Download Forms

McKesson Specialty Rx Forms

• Product List - List of medications available through McKesson Specialty Pharmacy
• General Enrollment Form - General McKesson patient enrollment form.
• RegenceRx Specialty & Injectable Medication Provider Manual

Medication Prior-Authorization Form

When using this form, you may either print, fax or submit on-line after the required information is included. Prior authorization for some medications requires corresponding chart notes be faxed with this form.

• Prior-Authorization Form

If you are having trouble opening this form, please clear your browser cache.

Mail Order Forms

• Postal Prescription Services (PPS) Registration & Prescription Order Form
• Walgreens Mail Service Registration & Prescription Mail Order Form
• Walgreens Prescription Fax Order Form

Authorization for Use and Disclosure of Protected Health Information

Authorization for a member's health care providers to disclose health information to a designated party for a specific purpose.

• Authorization to Disclose Protected Health Information - Regence BlueShield of Idaho
• Authorization to Disclose Protected Health Information - Regence BlueCross BlueShield of Oregon
• Authorization to Disclose Protected Health Information - Regence BlueCross BlueShield of Utah
• Authorization to Disclose Protected Health Information - Regence BlueShield (in much of the state of Washington)
• Authorization to Disclose Protected Health Information - Asuris Northwest Health