Prior Authorization Form

Online forms are a great chance to stop spending too much time managing prior authorization requests. With this template, you can collect all the necessary patient and provider details quickly and accurately. Open the form template and streamline your process today.
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How to use this prior authorization form

1. Import into your account

1. Import into your account

View this prior authorization form and click on "use template" after making sure this is what you are looking for.

2. Customize however you like

2. Customize however you like

Add or remove questions through forms.app's drag & drop interface and match your brand style.

3. Share it on all channels

3. Share it on all channels

Customize the URL, change the access levels, create a QR code, or get the embed code.

Need a custom template instead?

Just tell us what you’d like to create in a few words. forms.app AI will understand your use case and create a free template for you.

What is a prior authorization form?

A prior authorization form is a document used by healthcare providers to request approval for prescribed treatments or services. These forms ensure that the services align with insurance requirements and reduce delays. Using an online version simplifies submission and record-keeping for both providers and insurers.

Why use an online prior authorization form?

Using an online prior authorization form enhances efficiency in your healthcare practice. It eliminates paper-based errors and speeds up the process with features like electronic signatures, auto-saving data, and seamless integrations. Forms are securely stored online, ensuring compliance with privacy regulations.

What should you include in a prior authorization form?

A well-designed prior authorization form collects the critical information needed for quick approval. Here’s what to include:

  • Patient’s full name and contact information
  • Provider’s name, credentials, and NPI number
  • Details about the requested treatment or service
  • Diagnosis and medical history related to the request
  • Insurance plan and policy details
  • Authorization from the patient or guardian

Frequently asked questions about Prior Authorization Form?

Informed consent is the process of obtaining consent from a second party after explaining to them the risks and possibilities involved with the action they are consenting to. Health-care providers and researchers often use an informed consent form to get consent before they start a medical operation or research.

Getting online consent is not substantially different than getting consent with papers. In both cases, you have to present all the necessary information to your respondents, and they need to sign, check, or state that they give you their consent to start the procedure. Here are 3 ways you can obtain consent with online forms:

  • Collect e-signatures
  • Add a terms & conditions field
  • Ask for a written statement

While consent and waiver are often used interchangeably, they have different meanings. A waiver is a consent document used for relinquishing one’s rights or claims, whereas consent is a document used for giving permission to an action or activity that the person will be subjected to.

For example, you have to obtain consent when collecting, processing, and storing personal data. However, you have to request a waiver during IRB applications and research. Human subjects sign a waiver document and state that they have been told of potential adverse effects of the research and will not hold responsible the researchers for any injury. Waivers can also be used for medical treatments or extreme activities. 

You need a way to inform people and obtain their consent, and online forms are the ideal tool for this job because you can collect data and obtain consent at the same time. As a powerful form builder, forms.app has all the features you need and provide consent form templates to get you started easily. Here are steps you can follow to create your own consent form:

  1. Select a template or create a new form
  2. Add questions for information you want to collect
  3. Use the explanation or terms & conditions fields to inform your respondents
  4. Optionally add a signature field to obtain e-signatures
  5. Share your form or embed it on your website