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Provider Authorization Forms Main Menu










* For prior authorization requests of Behavioral Health Services, please contact Unison at 1.866.261.7692.



* To access Unison's Obstetrical Needs Assessment Form, please follow the below link and fax the completed form to 1.866.915.0313
Obstetrical Needs Assessment Form

* For delivery notifications, please complete Unison's Maternity Outcomes Authorization Form at the below link and fax to 1.866.915.0313.
Maternity Outcome Authorization Form

* If you have questions related to the Prior Authorization Request application or the results returned by this application, please contact Unison's Provider Services Department at 1.800.600.9007.