English - 014-4941-87e - Exceptional Access...
The purpose of the e-Form is to assist physicians in the EAP drug request process by integrating all the rules/criteria into an interactive e-Form that will ensure all the necessary information is captured.
Additional Information
| Last updated | December 11, 2021 |
|---|---|
| Created | December 11, 2021 |
| Format | |
| Form Number | https://forms.mgcs.gov.on.ca/dataset/924c6992-cf72-4d06-887a-eb1ce8a057fd/resource/0e5f8840-2a41-4374-94a4-19a5eec361a2/download/4941-87e_fragmin.pdf |
| Form File Identifier | |
| Name | English - 014-4941-87e - Exceptional Access Program (EAP) Request Fragmin (Dalteparin Sodium) Therapy |
| Form File Status | |
| Description | The purpose of the e-Form is to assist physicians in the EAP drug request process by integrating all the rules/criteria into an interactive e-Form that will ensure all the necessary information is captured. |
| Language | English |
| Functionality | |
| Form File Content Type | |
| Remark | |
| Edition Date |