| Assigned number | Title Sort descending | Release date | File type | Language | Available to order |
|---|---|---|---|---|---|
| F-11033 | Prior Authorization / Mental Health and/or Substance Abuse Evaluation Attachment (PA / EA) | 07/01/2012 | Word | English | No |
| F-11033 | Prior Authorization / Mental Health and/or Substance Abuse Evaluation Attachment (PA / EA) | 07/01/2012 | English | No | |
| F-11033A | Prior Authorization / Mental Health and/or Substance Abuse Evaluation Attachment (PA / EA) Completion Instructions | 10/01/2008 | English | No |
Last revised March 5, 2026