First Prescription Fill

First Prescription Fill Form

CompOne Administrators, Inc.
Workers’ Compensation Prescription Information
Use the form below to submit your request. Alternatively, you may download, print and mail a completed copy of the First Prescription Fill Form (PDF) to:

CompOne Administrators
PO Box 2530
Okemos, MI 48805

If you need a paper copy of your submission, please print the PDF and fill out with your information. If you choose to submit via the online form, your information is secure and sent directly to the CompOne team, but you will not receive a paper copy of your submission.