Ajovy (fremanezumab) – PSP Form – Migraine – EN – 2021e
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BC, eForms, Medication Coverage, Medication Exception, ON, QC
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April 19, 2021
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Download
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Ajovy (fremanezumab) PSP Formulaire – Migraine – FR -2021
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eForms, Medication Exception, QC
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April 19, 2021
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Download
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Amgevita (adalimumab) Enliven Formulaire de PSP FR – Feb 2021
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eForms, Medication Coverage, Medication Exception, QC
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April 27, 2021
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Download
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Amgevita (adalimumab) Enliven PSP Form EN – Feb 2021
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BC, eForms, Medication Coverage, Medication Exception, ON, QC
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April 27, 2021
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Download
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Asthma Refer ID Tool
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asthma, BC, eForms, Medication Coverage, ON, QC
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December 28, 2021
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Download
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Benlysta (belimumab) Formulaire d’Inscription PSP 10_21
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eForms, Medication Coverage, QC
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October 13, 2021
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Download
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Benlysta (belimumab) PSP Enrollment Form 10_21
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BC, eForms, Medication Coverage, ON, QC
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October 13, 2021
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Download
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Botox (onabotulinumtoxina) Formulaire d’inscription Abbvie Care-FR
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eForms, Medication Coverage, QC
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October 6, 2021
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Download
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Botox (onabotulinumtoxina) PSP Form Abbvie Care EN
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BC, eForms, Medication Coverage, ON, QC
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October 6, 2021
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Download
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Breo Ellipta Starter Kit Letter
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asthma, BC, eForms, Medication Coverage, ON, QC
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November 22, 2021
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Download
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Breo Ellipta Trousse de depart pour patient
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asthma, eForms, Medication Coverage, QC
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November 22, 2021
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Download
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Dexcom G6 Formulaire de prescription
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Diabetes, eForms, Medication Coverage, QC
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September 22, 2021
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Download
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Dexcom G6 Prescription Rx Form
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BC, Diabetes, eForms, Medication Coverage, ON, QC
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September 22, 2021
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Download
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Dexcom G6 – RAMQ Demande d’autorisation de paiement
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Diabetes, eForms, Medication Coverage, QC, RAMQ
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September 22, 2021
|
Download
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Duobrii Fiche d’Information Patient – FR 2021
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Dermatology, eForms, Medication Coverage, QC
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September 9, 2021
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Download
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Duobrii Patient Information Sheet – EN 2021
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BC, Dermatology, eForms, Medication Coverage, ON, QC
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September 9, 2021
|
Download
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Emgality (galcanezumab) LillyPlus Formulaire d’Inscription 2022
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eForms, Medication Coverage, Migraine, QC
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January 21, 2022
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Download
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Emgality (galcanezumab) LillyPlus PSP Form 2022
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BC, eForms, Medication Coverage, Migraine, ON, QC
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January 21, 2022
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Download
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Hadlima (adalimumab) Patient Support Program 2021 – EN
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BC, eForms, Medication Coverage, Medication Exception, ON, QC
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April 22, 2021
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Download
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Hadlima (adalimumab) Programme de soutien a l’intention des patients 2021 – FR
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eForms, Medication Coverage, Medication Exception, ON, QC
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April 27, 2021
|
Download
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Hulio (adalimumab) Formulaire de PSP FR – 2021
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eForms, Medication Coverage, Medication Exception, QC
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April 27, 2021
|
Download
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Hulio (adalimumab) PSP Form EN – 2021
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BC, eForms, Medication Coverage, Medication Exception, ON, QC
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April 27, 2021
|
Download
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Humira (adalimumab) PSP Form AbbVie Care-EN 11-21
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Arthritis, BC, eForms, Medication Coverage, ON, QC
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November 9, 2021
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Download
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Humira (adalimumab) PSP Formulaire d’inscription AbbVie Care-FR-11-21
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Arthritis, eForms, Medication Exception, QC
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November 9, 2021
|
Download
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Inflectra (infliximab) PfizerFlex Formulaire d’inscription PSP 2021
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Arthritis, eForms, Medication Coverage, QC
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November 24, 2021
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Download
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Inflectra (infliximab) PfizerFlex PSP Form 2021
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Arthritis, BC, eForms, Medication Coverage, ON, QC
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November 24, 2021
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Download
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Lupron (leuprolide acetate) Formulaire d’inscription Abbvie Care-FR
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Cancer, eForms, Medication Coverage, QC
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October 13, 2021
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Download
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Lupron (leuprolide acetate) PSP Form Abbvie Care-EN
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BC, Cancer, eForms, Medication Coverage, ON, QC
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October 13, 2021
|
Download
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Maviret (glecaprevir pibrentasvir) Formulaire d_inscription Abbvie Care-FR
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eForms, Hematology, Medication Coverage, QC
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September 22, 2021
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Download
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Maviret (glecaprevir pibrentasvir) PSP Form Abbvie Care-EN
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BC, eForms, Hematology, Medication Coverage, ON, QC
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September 22, 2021
|
Download
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Nucala_PSP_Enrollment_Form_Quebec_ENG_12-2021
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asthma, eForms, Medication Coverage, QC
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December 20, 2021
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Download
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Nucala_PSP_Enrollment_Form_Quebec_FRE_12-2021
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asthma, eForms, Medication Coverage, QC
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December 20, 2021
|
Download
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Olumiant_(baricitinib)_LillyPlus_Formulaire_d_Inscription_2021
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Arthritis, eForms, Medication Coverage, QC
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December 20, 2021
|
Download
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Olumiant_(baricitinib)_LillyPlus_PSP_Form_2021
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Arthritis, BC, eForms, Medication Coverage, ON, QC
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December 20, 2021
|
Download
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Orencia (abatacept) PSP Enrolment 12-21-EN
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Arthritis, BC, eForms, Medication Coverage, ON, QC
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January 13, 2022
|
Download
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Orencia (abatacept) PSP Inscription 12-21 -FR
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Arthritis, eForms, Medication Coverage, QC
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January 13, 2022
|
Download
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Otezla (apremilast) PSP Form Active Psoriatic Arthritis 2020-08
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eForms, Medication Coverage, Medication Exception, QC
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December 3, 2020
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Download
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Otezla PSP Formulaire d_inscription arthrite psoriasique evolutive 2020-08
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eForms, Medication Coverage, Medication Exception, QC
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December 3, 2020
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Download
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Outil Refer ID en asthma
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asthma, eForms, Medication Coverage, QC
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December 28, 2021
|
Download
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RAMQ Rx Payment Authorization – form 3996
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eForms, Medication Coverage, QC, RAMQ
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September 29, 2021
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Download
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Repatha (evolocumab) Canada Life Insurance Form
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BC, Cardiology, eForms, Medication Coverage, ON, QC
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January 10, 2022
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Download
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Repatha RepathaReady PSP Form 2020-11
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BC, eForms, Medication Coverage, Medication Exception, ON, QC
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December 3, 2020
|
Download
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RepereRepatha PSP Formulaire 2020-11
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eForms, Medication Coverage, Medication Exception, QC
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December 3, 2020
|
Download
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Rinvoq (upadacitinib) Formulaire d’inscription Abbvie Care-FR
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Arthritis, eForms, Medication Coverage, QC
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October 13, 2021
|
Download
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Rinvoq (upadacitinib) PSP Form Abbvie Care-EN
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Arthritis, BC, eForms, Medication Coverage, ON, QC
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October 13, 2021
|
Download
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Ruxience (rituximab) GPA MPA Pfizerflex PSP Form-2021
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Arthritis, BC, eForms, Medication Coverage, ON, QC
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November 24, 2021
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Download
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Ruxience (rituximab) GPA PAM Pfizerflex PSP Formulaire d inscription-2021
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Arthritis, eForms, Medication Coverage, QC
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November 24, 2021
|
Download
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Ruxience (rituximab) PR Pfizerflex PSP Formulaire d’inscription-2021
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Arthritis, eForms, Medication Coverage, QC
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November 24, 2021
|
Download
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Ruxience (rituximab) RA Pfizerflex PSP Form 2021
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Arthritis, BC, eForms, Medication Coverage, ON, QC
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November 24, 2021
|
Download
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Saxenda (liraglutide) Patient Starter Kit
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eForms, Medication Coverage, Medication Exception, QC
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December 3, 2020
|
Download
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Saxenda(liraglutide)Trousse de depart pour patient
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eForms, Medication Coverage, Medication Exception, QC
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December 3, 2020
|
Download
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Taltz (ixekizumab) LillyPlus Formulaire d’Inscription 2021
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Arthritis, eForms, Medication Coverage, QC
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November 24, 2021
|
Download
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Taltz (ixekizumab) LillyPlus PSP Form 2021
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Arthritis, BC, eForms, Medication Coverage, ON, QC
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November 24, 2021
|
Download
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Tresiba_(insulin_degludec)_Patient_Dosing_and_Titration_Tool_Cantonese-Mandarin
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BC, Diabetes, eForms, ON, QC
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December 20, 2021
|
Download
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Tresiba_(insulin_degludec)_Patient_Dosing_and_Titration_Tool_Spanish_Portuguese
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Diabetes, eForms, Medication Coverage, ON, QC
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December 20, 2021
|
Download
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Trulicity (dulaglutide)RAMQ Demande d’autorisation de paiement
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eForms, Medication Coverage, Medication Exception, QC, RAMQ
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October 6, 2021
|
Download
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Xeljanz (tofacitinib) Formulaire d’inscription PSP Pfizerflex-2021
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Arthritis, eForms, Medication Coverage, QC
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November 24, 2021
|
Download
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Xeljanz (tofacitinib) Pfizerflex PSP Form 2021
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Arthritis, BC, eForms, Medication Coverage, ON, QC
|
November 24, 2021
|
Download
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Xpose Patient Support Program 2020 English et Français
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Cancer, Consent, eForms, Hematology, Internal Medicine, Oncology, QC
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November 26, 2020
|
Download
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Xtandi XPAP Formulaire d’inscription et de consentement du patient Feb 2019
|
eForms, Medication Coverage, Oncology, QC
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July 8, 2019
|
Download
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Zeposia (ozanimod) PSP Enrolment and Risk Minimization Materials
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BC, eForms, Medication Coverage, Medication Exception, ON, QC
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April 19, 2021
|
Download
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Zeposia (ozanimod) PSP Inscription et Materiel de reduction des risques
|
eForms, Medication Coverage, Medication Exception, QC
|
April 19, 2021
|
Download
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