Prior Financial Authorisation for Ketamine, EsKetamine and TMS for Treatment Resistant Depression
Form ID
d9533
Audience
For providers
Psychiatrist
This form is used to request prior financial authorisation for Ketamine, EsKetamine and TMS for the treatment of Treatment Resistant Depression.
If you are using an Apple computer and want to fill out your form electronically, please download the form and open it with Acrobat 7 or later.
How can I access this form?
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Form file format