Effective Date: 2/2022
Complete this form:
- When initially applying to be a member of the Drug Utilization Review (DUR) board.
- Upon your initial appointment to the board.
- Each year as part of the annual attestation Process.
Appointment and Annual Attestation:
- Fax: 512-491-1962
Direct any questions about this form to the Vendor Drug Program at firstname.lastname@example.org.