Follow the steps to successfully complete the authorization form

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin filling out the form by entering the patient's name in the designated field. Ensure that the name matches the one on file with the pharmacy for accurate processing.
3. Input the patient's date of birth to verify their identity and match the records. This is an essential step to ensure proper authorization.
4. Provide the required phone number and fax number for the prescribing doctor. This allows the pharmacy to coordinate with the healthcare provider if necessary.
5. List the medications for which refill authorization is being requested. Be specific about each medication to prevent any confusion in the processing of refills.
6. Ask the prescribing doctor to sign the form and indicate the number of refills authorized. This section is critical for ensuring that the request is validated by a healthcare professional.
7. Once all fields are completed, save your changes. You can then download, print, or share the form as needed before submitting it back to Sqa Pharmacy.

Complete your refill authorization requests online to ensure timely medication access.