Request for Participation

• AzAHP Practitioner Practice – Change Form
• Request for Participation – AzAHP Practitioner Data Form
• AzAHP Organizational/Facility Application
• Non Delegated Group AzAHP Roster

Prior Authorization Forms

• Medical Services and Behavioral Health Prior Authorization Form
• Residential Services PA Request Form 12.12.23 SLRFSDrf
• Prior Authorization and Continued Stay Request Form for Psychiatric Inpatient and Sub-acute Facilities

Other Forms

• Care Management Referral Form
• Fraud Waste & Abuse Referral Form
• Newborn Reporting Form
• Pediatric NICU Case Management Referral Form