LACDMH Pharmacy Services/PBM Contacts
Medicare Part D Information
Medication Treatment Authorization Request (M-TAR)
LACDMH Manual Eligibility Update Request (for UNINSURED CLIENTS)
This form must be completed and sent through a secure email to firstname.lastname@example.org immediately after opening a new client episode or, for Correctional Health Facilities and Juvenile Justice Mental Health Services, immediately after closing an uninsured client’s episode.