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Forms and Applications
AKDC Applications
AKDC-01 Referral Application
- PDF
AKDC-02 Annual Renewal Application
AKDC-03 Request for Prior Approval Of Fosrenol/Renvela
- DOC
AKDC-04 Request for Prior Approval Of Sensipar
- DOC
AKDC Forms
AKDC-05 Client Status Change Report
- DOC
AKDC-06 Pharmacy Claim Form
- DOC
AKDC-07 Prescription Formulary
- XLS
AKDC-08 Dental Fee Schedule
- PDF
Rx Assistance Programs
Fosrenol
Sensipar
Renvela - Renassist Program