Referring patients to us is easy.

 

Click on a medication below to download the form to your computer or device. Open the form up in Adobe Acrobat reader.
Then you can click the fields and fill out your form. Save it and then fax it to 636-330-2363 or email your form to us at info@washingtonmedcenter.com.

Washington Medical Centers patient financial support will do all prior authorizations, coordinate benefits, and schedule the patient’s initial visit. Our staff will also communicate and provide periodic follow up on your patient’s progress.

*To download a free version of Adobe Acrobat Reader for Mac or PC -
go here: https://www.adobe.com/acrobat/pdf-reader.html

<Click the “Download PDF Reader” button < Above the blue “Download Acrobat Reader” button you will see very small text that says “More Download Options.” <Click that and you can select the Mac or PC operating system you have to download the version that will work best on your computer or device.

 

Can’t find what you’re looking for?

If the medication form your looking for is not listed, or you need help with a medication form please give us a call us at 636-202-9400. We want to make this a pleasant process for the doctor and patient.