Preauthorization Request Form

This Hyperhidrosis Preauthorization Request Form may be used to notify an insurance organization that you’ve been diagnosed with hyperhidrosis and to demonstrate the degree to which your life is negatively affected by excessive sweating. There is also space on the form for your physician to note treatments that you’ve already tried and the next treatment that he or she is recommending. The form should be completed and submitted to the appropriate health insurance organization by your treating physician. You can help your doctor by printing the form and taking it to your next appointment.