Pharmacy Medication Exception Approval Request Form

Streamline Medication Exception Approvals with Paperform

When a patient needs a medication that falls outside standard formulary guidelines, getting approval shouldn't mean drowning in paperwork. This Pharmacy Medication Exception Approval Request Form template helps healthcare organizations, pharmacy benefit managers, and clinical teams process exception requests efficiently while maintaining the thorough documentation required for medical director review.

Built for healthcare workflows that need speed and compliance

Whether you're a pharmacy operations manager, clinical pharmacist, or healthcare administrator, this template captures everything needed for a complete exception request: patient demographics, prescribing provider information, detailed clinical justification, formulary alternative review, and space for medical director authorization. The structured format ensures nothing gets missed while keeping the submission process straightforward for busy clinical staff.

Paperform's conditional logic means you can show or hide sections based on request type or urgency level, while calculations can track approval timelines and flag aging requests. Integration with tools like Google Sheets, Airtable, or your pharmacy management system means submissions flow directly into your tracking workflow without manual data entry.

Take it further with automation

Connect this form to Stepper (stepper.io) to automate what happens after submission: route requests to the appropriate medical director based on therapeutic category, send automatic status updates to the requesting pharmacist, create review tasks in your project management system, and update your pharmacy database once approved. If you need signed authorization documentation, Papersign (papersign.com) can turn approvals into compliant eSignature workflows with full audit trails.

Trusted by healthcare organizations for professional forms that balance compliance with usability, Paperform is SOC2 Type II and GDPR compliant, giving you the security foundation clinical workflows demand—without the complexity of enterprise-only platforms.