DPP-4 / SGLT2 Inhibitors Special Authorization Request Form
Special authorization request form to be completed by your physician or diagnosing specialist.
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Special authorization request form to be completed by your physician or diagnosing specialist.
Special authorization request form to be completed by your physician or diagnosing specialist.
Special authorization request form to be completed by your physician or diagnosing specialist.
Special authorization request form to be completed by your physician or diagnosing specialist.
Some medications in the PEI Pharmacare Formulary are approved on a special authorization basis only. If your physician prescribes a drug in this category, you can submit a Standard Special Authorization Request form to have a medication considered for coverage.
Women and Gender-Diverse People’s Health Section created A Guide to Applying Gender and Diversity Analysis (GDA) in Health for staff in the health sector.