Caremark Publications and Forms
- NALC Prescription Drugs with Dispensing Limits or Prior Authorization Requirements
- Specialty Pharmacy Drug List
- Formulary Drug List
If your physician believes a brand name drug is necessary, or there is no generic available, your physician may prescribe a brand name drug from our formulary list. These formulary brand name drugs are selected to meet patient needs at lower cost.
- Mail Order Prescription form
Complete this patient profile/order form. Send this form, along with your prescription(s) and payment.
- Short-Term Prescription form
If you purchase prescriptions at a non-network pharmacy, or elect to purchase additional refills at a preferred network pharmacy, or an NALC CareSelect Network pharmacy, complete the short-term prescription claim form. Mail it with your prescription receipts to the NALC Prescription Drug Program. Receipts must include the patient's name, prescription number, name of drug, prescribing doctor's name, date, charge, and name of pharmacy.
