Form
Neuromuscular disorder referral form – migraine, cervical dystonia, overactive bladder
Optum specialty referral form. Send us the form and we will take care of the rest.
![Neuromuscular disorder referral form – migraine, cervical dystonia, overactive bladder](/content/hub5/neuromuscular-disorder-enrollment-migraine/_jcr_content/root/container/container/column_half_copy_cop/col1/o4_adaptiveimage.jpg)
This is an Optum prior authorization criteria specific form to prescribe Botox treatment for migraines, cervical dystonia and overactive bladder from Optum Specialty Pharmacy.