This version of the form is not currently in use and is provided for reference only. Download this version of Form HLTH5365 for the current year.
Form HLTH5365 Special Authority Request - Targeted DMARDs for Ankylosing Spondylitis - Initial/Switch is a document used in British Columbia, Canada. It is used to request special authority for targeted DMARDs (Disease-Modifying Antirheumatic Drugs) for the treatment of Ankylosing Spondylitis, which is a type of inflammatory arthritis that primarily affects the spine. This form is used when initiating or switching to targeted DMARDs for the treatment of Ankylosing Spondylitis.
The Form HLTH5365 Special Authority Request is usually filed by the patient's healthcare provider or physician in British Columbia, Canada.
Q: What is the purpose of Form HLTH5365?
A: Form HLTH5365 is used to request special authority for targeted DMARDs for Ankylosing Spondylitis in British Columbia, Canada.
Q: What is Ankylosing Spondylitis?
A: Ankylosing Spondylitis is a type of arthritis that primarily affects the spine.
Q: What are targeted DMARDs?
A: Targeted DMARDs are disease-modifying anti-rheumatic drugs that specifically target the immune system to reduce inflammation and slow the progression of rheumatic diseases.
Q: Who can use Form HLTH5365?
A: Form HLTH5365 can be used by patients and healthcare providers in British Columbia, Canada.
Q: What is special authority?
A: Special authority is a process that allows certain medications to be covered by the provincial healthcare system in specific circumstances.
Q: What needs to be included in the special authority request?
A: The special authority request should include relevant clinical information, treatment history, and any supporting documentation.
Q: Is there a fee for submitting the special authority request?
A: No, there is no fee for submitting the special authority request.
Q: How long does it take to process a special authority request?
A: The processing time for a special authority request can vary, but it is typically within a few weeks.
Q: Can I appeal a denied special authority request?
A: Yes, there is an appeal process available for denied special authority requests.