Below you will find the list of Provider forms for TLC. Click any of the links below to view, download, or print the information needed.
DME Authorization
Home Health Authorization form
Hospice Authorization Request form
Infusion Authorization request form
Outpatient Diagnostic Imaging Authorization
Outpatient Procedure Authorization
Outpatient Rehab Authorization request form
Practitioner Load Form - for adding new providers to an existing contract and/or hospital based providers
Provider Loading Form - for out of network referring providers
PCCM Change Form
Referral form
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