By Dr. Maurice Shaw on LinkedIn
If we created prior authorization for customers to transfer to your pharmacy
🔥 PRIOR AUTHORIZATION FORM FOR TRANSFERRING TO THIS PHARMACY 🔥
(Because it ain’t that simple anymore…)
Patient Name: ___________________________
DOB: //______
Preferred Pronunciation of Your Own Name (Because You’ll Be Mad When We Get It Wrong): ___________________
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Section A: Justification for Transfer
☐ I’m mad at the other pharmacy because they made me wait 15 minutes like that’s a felony.
☐ My ex works at the other pharmacy and I’m trying to be petty.
☐ I called them 14 times and they still ain’t pick up.
☐ They told me they “ran out of stock” but I saw it on the shelf through the drive-thru window.
☐ Walgreens made me get a flu shot and I only went in for condoms.
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Section B: Customer Behavior Screening
☐ I promise not to say “My doctor sent it over yesterday” when it was actually 3 hours ago.
☐ I will not hand over sweaty bra money.
☐ I will wait my turn in line and not yell “I JUST NEED TO PICK UP” like I’m Beyoncé.
☐ I understand that yelling “I’ll just call corporate!” does not speed up the process.
☐ I know the pharmacy closes at 6. Showing up at 5:59 is not a heroic act.
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Section C: Copay and Coupon Literacy
☐ I will not ask “Why do I have a copay?” like you personally charged me.
☐ I will not try to use 8 different GoodRx cards like it’s a scratch-off ticket.
☐ I understand “the street price” is not a valid reference.
☐ I won’t argue about brand vs. generic like I got a PhD from TikTok.
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Section D: Final Verification
☐ I solemnly swear I won’t call 12 minutes after pickup time asking “Is it ready yet?”
☐ I understand that this pharmacy is not Amazon Prime.
☐ I acknowledge that the pharmacist is not my therapist, spiritual advisor, or co-parent.
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Signature of Patient (or their cousin who always picks up their meds): _______________________________
Date: //______
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Approval Decision:
✅ Approved – welcome to the chaos!
❌ Denied – return to the pharmacy that raised you.
