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Oncology Treatment Plan Prior Authorization Request Form Fax to: (316) 9282539 SECTION 1: MEMBER INFORMATION Member Rebirth Date (mm/dd/YYY)Insurance ID NumberPhone NumberSECTION 2: REQUESTING / ORDERING

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How to fill out return to name

01

Start by writing the recipient's name on the very first line of the return address section.

02

Follow the name with any pertinent titles or suffixes, such as 'Mr.', 'Mrs.', or 'Jr.'

03

On the next line, write the recipient's street address. Include any apartment or unit numbers if applicable.

04

Then comes the city, followed by the state or province, and the postal code.

05

Finally, write the country name on the last line of the return address.

06

Make sure to use clear and legible handwriting when filling out the return to name.

Who needs return to name?

01

Anyone who is sending mail or packages and wants to ensure that it can be returned to the correct sender needs to include a return to name on their correspondence.

02

This is particularly important for individuals or businesses that frequently send out mail, as it helps facilitate the return process if the item cannot be delivered.

03

Including a return to name can also be helpful when sending important documents or sensitive information, as it provides an additional layer of identification for the sender.

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What is return to name?

Return to name is a form or document that includes the name of the person or entity who is receiving a returned item or package.

Who is required to file return to name?

Anyone who is receiving a return item or package is required to file return to name.

How to fill out return to name?

You can fill out return to name by providing your name or the name of the entity receiving the return item or package.

What is the purpose of return to name?

The purpose of return to name is to ensure that the return item or package is properly received by the intended recipient.

What information must be reported on return to name?

The information that must be reported on return to name includes the name of the recipient and any additional instructions for the return.

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