We've provided a number of different forms and letters to help you. If you don't see a form you need, please contact us at
- Patient Authorization to Disclose Health Information (HIPAA) (PDF - 108 KB)
- AAP Application for Protopic (PDF - 335 KB)
- Sample Letter of Medical Necessity (PDF - 201 KB)
- Sample Letter of Denial Appeal (PDF - 227 KB)
- Sample Letter of Medicare Carrier Advisory Letter (PDF - 200 KB)
