Alabama

PA Forms
PDL Instructions
PDL Reference Tool
Newsletters
Override Instructions
Max Units List
Prenatal Vitamins by NDC
Synagis Information
Programs/Pharmacy/Drug Lookup
First Generation Antihistamines
Covered Nicotine Products

PA Forms

All of the forms are in .pdf format. You must have Adobe Acrobat Reader to view the forms. If you do not have Adobe Acrobat Reader, we recommend downloading and installing the latest version.

New Form Submission:
You can now fill out and submit your Prior Authorization and Override requests online.
Submit Request Online

PA Forms