Prior Authorization (PA) Form Finder

To obtain a PA form from a health plan's Web site, please select location, health plan type and health plan name from the menu below. Once these selections have been made, you will be redirected to the health plan's site.

Location California
Health Plan Type Non-Medicare

PA criteria and forms may vary depending on the type of health plan. Some health plans may provide general PA forms while others will be specific to individual products.

Use Formulary Finder to confirm the formulary status and determine if a PA is required for
CELEBREX® (celecoxib) capsules, LYRICA® (pregabalin) Capsules CV, and FLECTOR® Patch (diclofenac epolamine topical patch) 1.3%.

Note: Some patients may have two different types of health insurance cards. One is a health plan card, which covers a patient's doctor visit. The other card is a prescription drug card that covers a patient's medicines. Be sure to have a patient's prescription drug information when searching for a product's prescription drug coverage or PA form information.