Member reimbursement Form
Looking for reimbursement on covered drug costs?
View and fill out this instructional form below!
All Member Forms
Member/Patient Forms
If you are a member looking to fill a form or file a pharmacy claim, view the available forms below.
For Physicians
Physician Forms
If you are a physician looking to fill a form or file a prior authorization request, view the available forms below.
Note: UF Health in Gainesville must use the UF Health Pharmacy at Medical Plaza for mail order prescriptions. They can be reached at 352-265-8270.
Medicare Creditable Coverage
For the Medicare Creditable Coverage document, please click here.