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014-5109-20
Specialty Vape Store RegistrationFor retailers that primarily sell vapour products to apply for a specialty vape store registration.014-0918-84
Remittance Advice InquiryForm used by physicians to make inquiries regarding payment details on Remittance Adviceon00315
Consent Form for the Inherited Metabolic Diseases (IMD) ProgramConsent Form for the Inherited Metabolic Diseases (IMD) Program014-4340-84
Primary Care - Time and Location of After Hours ServicesForm used to record hours of physicians in after hours clinics014-4474e-67
Prior Testing Disclosure - Powered Mobility DevicesThis form is used by Manufacturers to report testing of Powered Mobility Devices014-5068-39
Health and Well-Being Grant Program Statement of InterestStatement of Interest application form for the Health and Well-Being Grant Program014-5069-87
Drug Benefit Claim Reversal FormUsed by pharmacies for submitting claims or reversals014-3766-41
Form 50 - Confirmation of Rights Advice014-4858-87
Request for Ilaris® (canakinumab)Application for drug funding
