Change Font Size:

Dean Pharmacy / Authorization to Release Pharmacy Records

All requests for pharmacy information require a signed authorization to release such information.

Please print and fill out the Authorization to Release Pharmacy Records Form (PDF) and mail to:

Dean Pharmacy Insurance Department
1808 West Beltline Highway
Madison, WI 53713

Note: To view the PDF application form you will need Adobe Acrobat Reader.

Print This Page  |  Send to friend