[Lab.MedicalProviders] Updated Preauthorization Form

[Smith, Trudy]

Good morning, the Request for Preauthorization has been updated.  The revised form can be found on our website at:
https://labor.vermont.gov/sites/labor/files/doc_library/Pre-Authorization%20Form%20%28fillable%29.pdf.



[3-300_StateVT_Vector logo_356 (2) (002)]
Trudy Smith
Vocational Rehabilitation Specialist

Vermont Department of Labor
5 Green Mountain Drive
P.O. Box 488
Montpelier, VT 05601-0488
(p) 802.828.2991 (f) 802.828.2195
trudy.smith at vermont.gov<mailto:trudy.smith at vermont.gov>
www.labor.vermont.gov<http://www.labor.vermont.gov>


CONFIDENTIALITY/DISCLOSURE NOTICE:
Please note that this email message, along with any response or reply, may be considered public record, and thus, subject to disclosure under the Vermont Public Records Law (1 V.S.A Ch. 5, Sec. 3, §§ 315-320<http://legislature.vermont.gov/statutes/chapter/01/005>). Thank You.

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