Important Forms

Below are forms that FirstCare providers can access for medical authorizations, behavioral health services, pharmacy needs, and more.
 

Medical Forms

Prior authorization requests, authorization check lists, treatment forms, clinical data forms, and more.

Behavioral Health Forms

Forms for behavioral health services.

Pharmacy Information

Prescription drug formularies, enrollment forms (specialty and mail order pharmacy), etc.

Case Management/Disease Management Referrals

We're here to help.

Our Provider Relations Team is here for you. If you have questions, please email Provider_Relations@FirstCare.com, or contact your provider relations representative at the number below:
  • Abilene area—1.325.670.3882 or 1.325.670.3884
  • Amarillo area—1.806.467.3200
  • Lubbock, Waco & other areas—1.806.784.4380

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