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Invoked (Canagliflozin/) Prior Authorization Request Form Caterpillar Prescription Drug Benefit Phone: 8772287909 Fax: 8004247640 Instructions: Please fill out all applicable sections completely and

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1. To fill out please provide documentation, follow these steps:
2. Start by gathering all the necessary documents that need to be submitted.
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4. Fill out any required forms or application materials accurately and legibly.
5. Arrange the documents in the prescribed order, if any.
6. Make copies of all the documents for your record, if needed.
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8. Submit the filled-out documentation along with any supporting materials, if required.
9. Keep a copy of the submitted documentation acknowledgment, if provided.
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