This form is used by parties appearing before the Fire Safety Commission to identify their legal representative.
To register ESRD patients for Special Drug Program for provision of Eythropoietins.
Application for reimbursement of cost due to use of Visudyne
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.
To allow patient advocacy groups to register into the database so that they provide written submissions to the ministry on a drug; the form is to make sure all the appropriate information is provided.
For faster decisions, prescribers can use the SADIE online portal to submit requests to the Exceptional Access Program (EAP). Sign in through GO Secure (
https://www.ebse.health.gov.on.ca) and select SADIE from the services drop-down menu. Visit the SADIE website for more information:
http://www.ontario.ca/sadie. Alternatively, this form can be used for submitting requests to the EAP by fax.
To facilitate physician's in making an EAP request for funding/reimbursement of Elaprase for Hunter's Syndrome.
Used for obtaining authorization for nutrition products as an ODB benefit under certai circumstances
Application for services of a homemaker or a nurse
