{** * Prior auth form * * @package OpenEMR * @link http://www.open-emr.org * @author Brady Miller * @copyright Copyright (c) 2017-2020 Brady Miller * @license https://github.com/openemr/openemr/blob/master/LICENSE GNU General Public License 3 *} {xlt t='Prior Authorization'} {headerTemplate assets='datetime-picker'} {literal} {/literal}

{xlt t="Prior Authorization"}

{xlt t="Details"}
{xlt t="Comments"}