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Click ‘Get Form’ to open the Sun Life Drug Exception Application Form in the editor.
Begin by filling out the Plan Member information section. Enter your Contract number, Member ID number, last name, first name, address, date of birth, and daytime telephone number. Ensure all fields are completed accurately.
In the Claimant information section, provide details about the claimant including their last name, first name, date of birth, relationship to the Plan Member, and select the reason for request from the options provided.
Proceed to the Authorization and signature section. Review your information for accuracy and sign electronically. Include the date of signing.
If applicable, have your prescribing physician complete the reverse side of the form. They will need to provide details about the medical condition and treatment required.
Once all sections are filled out completely, save your document and follow mailing instructions to submit it as directed.
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