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INITIAL REQUEST: ANTIOBESITY MEDICATION PRIOR AUTHORIZATION REQUEST FORM Community Health Pharmacy Management Telephone: 317.621.7575 Option 2, then Option 5 / 800.344.8672 Fax: 317.355.6229 Member
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How to fill out initial request anti-obesity medication
How to fill out initial request anti-obesity medication
01
Gather all necessary information and documentation such as medical history, weight history, and any previous attempts at weight loss.
02
Contact a healthcare professional or specialist who can prescribe anti-obesity medication.
03
Schedule an initial consultation or appointment to discuss your weight loss goals and determine if anti-obesity medication is a suitable option for you.
04
During the appointment, provide the healthcare professional with all the gathered information and answer any questions they may have.
05
Follow any specific instructions provided by the healthcare professional regarding the initial request process, such as filling out forms or providing additional documentation.
06
Complete the initial request form accurately and thoroughly, ensuring all required fields are filled out.
07
Double-check all the information provided before submitting the request.
08
Submit the initial request form to the healthcare professional or the designated office through the preferred method, which could be in person, via mail, or electronically.
09
Follow up with the healthcare professional or their office to confirm the receipt of the initial request and inquire about the next steps in the process.
10
Stay in contact with the healthcare professional throughout the process and follow any additional instructions or recommendations they provide.
Who needs initial request anti-obesity medication?
01
Individuals who are diagnosed as obese or severely overweight may need initial request anti-obesity medication.
02
People who have unsuccessfully tried other weight loss methods and have a medical need for pharmacological intervention may also require these medications.
03
It is important to consult with a healthcare professional to determine if anti-obesity medication is appropriate and safe for an individual's specific situation.
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What is initial request anti-obesity medication?
Initial request anti-obesity medication is a formal request made by an individual to obtain medication to help with weight management and obesity treatment.
Who is required to file initial request anti-obesity medication?
Individuals who are seeking anti-obesity medication as part of their medical treatment plan are required to file the initial request.
How to fill out initial request anti-obesity medication?
To fill out the initial request, individuals need to provide their personal information, medical history, and justification for the need of anti-obesity medication.
What is the purpose of initial request anti-obesity medication?
The purpose of the initial request is to assess the medical necessity and eligibility of the individual for anti-obesity medication.
What information must be reported on initial request anti-obesity medication?
The information required may include personal details, medical history, current medications, and the reason for requesting anti-obesity medication.
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