PDF
Word
This version of the form is not currently in use and is provided for reference only. Download this version of
Form HLTH5361
for the current year.
Form HLTH5361 Pharmacare Special Authority Request - Targeted Dmards for Psoriatic Arthritis - Renewal / Dosing Adjustment - British Columbia, Canada
Form HLTH5361 Pharmacare Special Authority Request - Targeted Dmards for Psoriatic Arthritis - Renewal/Dosing Adjustment is used in British Columbia, Canada to request special authority for targeted DMARDs (Disease-Modifying Antirheumatic Drugs) for the treatment of Psoriatic Arthritis. It is used for renewal or dosage adjustment purposes.
The Form HLTH5361 Pharmacare Special Authority Request - Targeted Dmards for Psoriatic Arthritis - Renewal/Dosing Adjustment in British Columbia, Canada is typically filed by the patient or their healthcare provider.
FAQ
Q: What is the form for Pharmacare Special Authority Request?
A: HLTH5361
Q: What is the form used for?
A: Targeted Dmards for Psoriatic Arthritis - Renewal/Dosing Adjustment
Q: Which province is this form for?
A: British Columbia, Canada
Download Form HLTH5361 Pharmacare Special Authority Request - Targeted Dmards for Psoriatic Arthritis - Renewal / Dosing Adjustment - British Columbia, Canada
1
2
