| Assigned Number | Title | Release Date | File Type | Language | Available to Order |
|---|---|---|---|---|---|
| F-11040 | Prior Authorization / Child / Adolescent Day Treatment Attachment (PA/CADTA) | 12/16/2019 | English | No | |
| F-11040A | Prior Authorization / Child / Adolescent Day Treatment Attachment (PA/CADTA) Instructions | 12/16/2019 | English | No | |
| F-11040 | Prior Authorization / Child / Adolescent Day Treatment Attachment (PA/CADTA) | 12/16/2019 | Word | English | No |
Last revised September 23, 2024