Preauthorization Request

At Innovative Care Management, it is always our goal to provide the most convenient, simple and helpful resources to the people we work with everyday. As an alternative to calling in a preauthorization request, you may use these forms to request a preauthorization at your convenience.

How this process works:

Submitting a Preauthorization Request is a simple alternative to calling our office. Complete one of the forms (select the appropriate one depending on the requested service) and submit the completed form along with pertinent/requested clinical information to ICM for review. You may submit by uploading documents to our secure website (click to upload files), via fax to 503-654-8570, or by secure email to

Please note that standard email is not secure and as such, confidential information should not be transmitted by standard email. Many organizations have access to secure email systems; if your organization doesn’t, please submit requests via the upload option or by fax.