Form PA-105 Out of State Prior Authorization Request Form - South Dakota

What Is Form PA-105?

This is a legal form that was released by the South Dakota Department of Social Services - a government authority operating within South Dakota. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

• Released on October 1, 2022;
• The latest edition provided by the South Dakota Department of Social Services;
• Easy to use and ready to print;
• Quick to customize;
• Compatible with most PDF-viewing applications;
• Fill out the form in our online filing application.

Download a fillable version of Form PA-105 by clicking the link below or browse more documents and templates provided by the South Dakota Department of Social Services.