Fill out pharmacy insurance forms in your browser

Prior authorizations, Medicaid and DME claim forms, billing sheets — drop fields onto any PDF, fill it in and sign, free and in your browser.

For a busy pharmacy the bottleneck usually isn't dispensing — it's the prior authorization. High-cost drugs, compounded prescriptions, and DME like diabetic supplies and nebulizers all stall behind a payer's PA form or a Medicaid claim (eMedNY, if you're in New York), and each one arrives as a flat PDF waiting to be typed by hand. This free tool lets you open any of those forms, drop your NPI, the drug and NDC details, and the prescriber's information into place, sign, and print or submit a finished PDF. It runs entirely on your own machine, so protected patient and prescription data never travels anywhere.

Frequently asked questions

Which pharmacy forms does it work with?+

Any PDF — payer prior-authorization requests, Medicaid claim forms such as eMedNY, and DME and compounding billing sheets. Because you place the fields yourself, a payer's own PA template works as well as a standard one.

Is protected health information kept safe?+

Yes — nothing is transmitted or stored. The form and every field you type stay in your browser on your computer, so PHI never leaves the pharmacy.

We run the same PA for dozens of patients — can this speed that up?+

The free tool completes one form at a time. Auto-filling a PA or claim for every patient from your pharmacy system is where a dojobase account takes over.

Filling the same form all day?

dojobase can auto-fill an insurance form for every patient from your pharmacy data — so paperwork stops being a person's whole afternoon.

Open the free Fill & Sign tool →