PET Scan Prior Authorization Request Form

PET Scan Prior Authorization Made Simple

Submitting prior authorization requests for PET scans doesn't have to mean juggling multiple phone calls, faxes, and incomplete documentation. This PET Scan Prior Authorization Request Form gives oncology practices, radiology departments, and healthcare facilities a professional, compliant way to gather all required information in one organized submission.

Built for Oncology Workflows

Whether you're requesting authorization for initial cancer staging, treatment response assessment, or surveillance imaging, this template captures everything insurance carriers need to make a determination—patient demographics, detailed clinical indications, cancer staging details, prior imaging history, and ordering physician credentials. The structured format reduces back-and-forth delays and helps your team move patients toward diagnostic clarity faster.

Why Healthcare Teams Choose Paperform

Paperform is trusted by healthcare providers who need secure, compliant forms that work within existing clinical workflows. Unlike generic form builders, Paperform offers conditional logic to show relevant fields based on scan indication, calculations for automatic urgency flagging, and seamless integrations with practice management systems, EHR platforms, and insurance portals via Stepper.

With SOC 2 Type II compliance, role-based permissions, and data residency controls, your authorization requests stay secure from submission through approval. You can route completed forms directly to insurance verification teams, trigger follow-up workflows in your PM system, or export data to match payer-specific submission requirements—all without developers or IT tickets.

Automate What Comes Next

Once a prior authorization request is submitted, use Stepper to automatically log the request in your tracking system, send confirmation emails to ordering physicians, set follow-up reminders for pending determinations, and notify clinical staff when approvals arrive. This keeps your team coordinated and ensures no authorization request falls through the cracks while patients are waiting for critical diagnostic imaging.

Paperform is not a HIPAA compliant solution. Please ensure your use case aligns with applicable compliance requirements.