Get Trow Prime Travel Form

The Trow Prime Travel Form is essential for users seeking authorization for travel to specialty medical appointments. This guide provides a clear, step-by-step approach to filling out the form online, ensuring a seamless experience.

Follow the steps to complete the Trow Prime Travel Form accurately.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by filling in the date at the top of the form, which indicates when the request is being submitted.
3. Provide patient information by entering the patient's full name, date of birth, and Social Security number (SSN). Fill in the patient's address including city, state, and zip code, as well as the home phone number and email address.
4. Complete the Primary Care Manager (PCM) information by filling in the PCM's name, address, city, state, zip code, and phone number.
5. Note the TriWest referral authorization number and authorization number as required for tracking and approval purposes.
6. In the appointment information section, provide the travel departure and return dates, as well as the specialty care provider (SCP) information, including name, address, phone number, and appointment dates/times.
7. Fill in the sponsor information including name, SSN, and status (active duty or retired) along with the mode of travel details.
8. If applicable, provide non-medical attendant (NMA) information including the NMA's name, SSN, rank, relationship, and relevant military details.
9. Ensure to input all required details related to the civilian federal employee NMA, including unit name, address, position, grade, and employer details.
10. Review the form for accuracy, then proceed to save changes, download, print, or share the completed form as required.

Complete your Trow Prime Travel Form online today to ensure timely travel authorization for your medical appointments.