Medical Provider Forms
Get fast, easy access to downloadable forms.
Medical Prior Authorization
Download medical prior authorization forms here.
Find Medical Prior Authorization Forms
Pharmacy Prior Authorization
Download pharmacy prior authorization forms here.
Find Pharmacy Prior Authorization Forms
Notice of Medicare Non-Coverage (NOMINC) Form
Download NOMNC Forms here. These forms are for Skilled Nursing Facilities, Comprehensive Outpatient Rehabilitation Facilities, and Home Health Providers.
View NOMNC Forms
Personal Designation
Providers may submit the completed form on behalf of the member by emailing HIPAAForms@upmc.edu. The submitted form will be processed within 1-2 business days.