Skip to Main Content

Forms & Brochures

How to View and Download Files

To view or download a file, click the desired language link. The PDF file will open in a new window or tab of your browser. From there, you can also download or print the file.

Pharmacy and Prior Authorization Forms

Commercial, CalViva Health & Medi-Cal Plans

Pharmacy Prior Authorization Form - English (PDF)

Medicare & Cal MediConnect Plans

Medicare Prior Authorization Form - English (PDF)
Cal MediConnect Prior Authorization Form - English (PDF)
Medicare Hospice Form - English (PDF)

Covered DME and Home Respiratory Services

Apria Covered DME and Home Respiratory Services - English (PDF)

Last Updated: 07/06/2020