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PRESCRIPTION DRUG MEDICATION REQUEST FORM FAX TO 18662408123 EXTENDED RELEASE OPIOID PRIOR AUTHORIZATION FORM PATIENT INFORMATION Subscriber ID Supergroup NumberPatient Impatient Telephone NumberPatient

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What is extended release opioid prior?

Extended release opioid prior is a process of obtaining authorization for extended release opioid medications before they can be dispensed to patients.

Who is required to file extended release opioid prior?

Healthcare providers and pharmacies are required to file extended release opioid prior.

How to fill out extended release opioid prior?

Extended release opioid prior can be filled out online or through a designated platform provided by the relevant authorities.

What is the purpose of extended release opioid prior?

The purpose of extended release opioid prior is to prevent misuse, abuse, and diversion of extended release opioid medications.

What information must be reported on extended release opioid prior?

Information such as patient details, prescriber information, medication details, and justification for the use of extended release opioid medications must be reported on extended release opioid prior.

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