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Prior Authorization Form

Draft of Uniform Prior Authorization Form for Update

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Draft of Uniform Prior Authorization Form (205.37 KB)

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Department of Financial Regulation

Commissioner Kevin Gaffney
89 Main Street • Montpelier, VT 05620-3101
(802) 828-3301 - Main
(833) 337-4685 (toll free)

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Insurance:
Consumers (802) 828-3302
Adjusters/Producers (802) 828-3303
Companies (802) 828-2470

Banking: (802) 828-3307
Captive Insurance: (802) 828-3304
Securities: (802) 828-3420

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Records Custodian: Victoria Hudson
(802) 828-4872 | Public records/Media inquiries

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