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Amharic Washington 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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Namzaric is a medication used to treat symptoms of Alzheimer's disease.
Healthcare providers or facilities prescribing and administering Namzaric in the state of Washington may be required to file certain reports.
Namzaric-Washington reports can typically be filled out online through the state's reporting system.
The purpose of Namzaric-Washington reports is to track the prescribing and administering of the medication in the state for regulatory and public health purposes.
Information such as patient demographics, prescribing healthcare provider, dosage information, and any potential adverse reactions must be reported on Namzaric-Washington reports.
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