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This version of the form is not currently in use and is provided for reference only. Download this version of
Form 1325
for the current year.
Form 1325 Synagis Prior Authorization Addendum (Cshcn) - Texas
What Is Form 1325?
This is a legal form that was released by the Texas Health and Human Services - a government authority operating within Texas. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form 1325 Synagis Prior Authorization Addendum?
A: Form 1325 Synagis Prior Authorization Addendum is a document used in Texas for children with special healthcare needs (CSHCN) to request prior authorization for the medication Synagis.
Q: What is Synagis?
A: Synagis is a medication used to prevent serious respiratory tract infections in children at high risk, particularly premature infants.
Q: Who uses Form 1325 Synagis Prior Authorization Addendum?
A: Form 1325 Synagis Prior Authorization Addendum is used by parents or guardians of children with special healthcare needs in Texas.
Q: What is the purpose of Form 1325 Synagis Prior Authorization Addendum?
A: The purpose of this form is to request prior authorization for the medication Synagis for a child with special healthcare needs in Texas.
Form Details:
- Released on November 1, 2020;
- The latest edition provided by the Texas Health and Human Services;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form 1325 by clicking the link below or browse more documents and templates provided by the Texas Health and Human Services.
Download Form 1325 Synagis Prior Authorization Addendum (Cshcn) - Texas
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