This form is available on the Ontario Drug Benefit Program Online Applications and Forms website :
https://forms.ontariodrugbenefit.ca/.
If you are not able to complete the form online, please contact the TDP at 416-642-3038 (Toronto area) or 1-800-575-5386 (outside Toronto) for a paper version of this form.
To facilitate prescribers making reimbursement claims for treatment of Hurler-Scheie and Hurler disease
To facilitate prescribers making reimbursement claims for treatment of Niemann Pick Type C (NIPC).
To provide patient advocacy groups with a template for written submissions to the ministry on a drug; the form is to make sure all the appropriate information is provided.
Application form for drug therapy for Fabry disease
Renewal form dor drug therapy for Fabry disease
