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Fax completed prior authorization request form to 8008547614 or submit Electronic Prior Authorization through CoverMyMeds or Subscripts. All requested data must be provided. Incomplete forms or forms
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It is a form for requesting access to cytokine CAM antagonist drugs approved by the Medical Control Authority of Zimbabwe and the Drug Control and Supplies division of the Ministry of Health and Child Care.
Healthcare professionals and facilities seeking to utilize cytokine CAM antagonist drugs in Zimbabwe.
The form should be completed with all required information including patient details, drug information, and justification for use.
The purpose of the form is to request access to specific drugs for treating patients with inflammatory disorders.
The form requires details such as patient's name, age, diagnosis, drug name, dose, duration, and prescriber information.
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