PA Assistance

We’ll Do All the Leg Work — You Just Make the Request

Need help with a Prior Authorization? Our pharmacy team is here to take the burden off your office. Just send us the request, and we’ll handle the paperwork, follow-ups, and communication with insurers — quickly and efficiently.

Partner with us for hassle-free PA support.

Patient Name

First Name

Last Name

Patient Date of Birth

YYYY

Patient Phone Number

(###)

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Medication

Provider Name

Provider Phone Number

(###)

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PA Assistance

We’ll Do All the Leg Work — You Just Make the Request

Lumen Pharmacy

Hours