Antipsychotic Medications (Pediatric) (Age <18 years old) Prior Authorization Form

Health Access, Dept. of Vermont

This government document is issued by Health Access, Dept. of Vermont for use in Vermont

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File Details: PDF (153 KB)
Source
https://dvha.vermont.gov/sites/dvha/files/doc_library/Antipsychotic%28pediatric%29%202023.06.pdf

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