Musculoskeletal Services Authorization Medical Records
Form Template
Use the Musculoskeletal Services Authorization Medical Records mobile app to provide medical documentation from onset/date of injury, including but not limited to: exam narrative, office notes, and results of diagnostic tests and/or any equivalent notes which demonstrate your patient’s condition and/or progress to date.
5,000 Companies save time and money with GoCanvas






Submission of this app, without medical records, will limit our ability to administer prior authorization. The app includes Diagnoses (ICD-9/10 Code) for Primary and Secondary Diagnosis and Services Requested (CPT /HCPCS) Codes. GoCanvas is utilized by numerous health care workers in a highly secure fashion including hospitals, doctors, nurses and home health care providers.
Not quite right?
GoCanvas accounts come
with hundreds of form templates




Don't take our word for it...
“I’m not a tech guy and I was able to pick this thing up in probably an hour, and actually start to build apps. I’ve done them over lunch when I’ve gotten frustrated with a process that didn’t exist in our company. So for non tech people who’ve got a problem, the support here is awesome and I’d recommend it to anybody, not just in our industry.”