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SALT 2 Inhibitors Prior Authorization Request Form Please complete this entire form and fax it to: 8669407328. If you have questions, please call 8003106826. This form may contain multiple pages.
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Take the medication with or without food, as directed by your healthcare provider.
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Take the medication at the same time each day to maintain a consistent level in your body.
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SGLT2 inhibitors are a class of medications used to lower blood sugar levels in people with type 2 diabetes by preventing the reabsorption of glucose in the kidneys.
Individuals diagnosed with type 2 diabetes who are prescribed SGLT2 inhibitors by their healthcare providers are required to report their use of these medications as part of their medical management.
To fill out a prescription for SGLT2 inhibitors, patients should provide their healthcare provider with detailed information regarding their medical history, current medications, and any other relevant health data.
The purpose of SGLT2 inhibitors is to help manage blood sugar levels in adults with type 2 diabetes, reduce the risk of cardiovascular events, and promote weight loss.
Patients must report their dosage, frequency of use, any side effects experienced, and how well the medication is managing their blood sugar levels.
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