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Medication Coverage

Collection of Special Authority forms/drug coverage forms/etc - Special Authority Forms are now being rejected (Feb 2015) unless there is a 'wet' signature. Forms have been updated to reflect this. Also an attempt was made to increase font size where possible to improve legibility.
Special Authority Request - Generic Form 2017
Updated because of Changes to the Cholinesterase Inhibitor forms.
Special Authority Forms Updated August 2016
Created by John Yap - Antivirals for Chronic Hep C, and New SA form for PPIs.
SA_NOAC_V7_Jun6_2018.zip
Updated to check for calcium channel blocker (non-dihydropyridine) interaction. Warning - combined with Cardizem/Verapamil, drug levels of NOAC may DOUBLE!
BC Special Authority Forms September 2015
**CI's removed in favour of 2017 version**Oral Diabetes agents, Cholinesterase Inhibitors, Long Acting Muscarinig Agonists -- Pharmacare Special Authority Request for pharmacare coverage of prescribed medications. Updated September 2015 by John Yap. Now includes signature area and updated web pages --- Includes low molecular weight heparin, oral glucose lowering agents, Cholinesterase inhibitors and Long Acting Muscarinic Agonists (LAMAs)
Special Authority Plan G Form BC February 2016
Edited to fit with other forms and menu added. Please delete the previous PlanG eform prior to uploading this one. It will not upload if there is an eform with the same name already present. For special Authority Psychiatric Medication. Includes a link to the web page for prescribers, calendars, a signature area, and conversion of current user from Lastname, Firstname to Firstname Lastname.
Special Authority BC COPD 2016
Special Authority Form for COPD for BC updated February 18th 2016 supplied by OSCARWest
BC Special Authority for Ticagrelor
BC Fair Pharmacare funding for Ticagrelor. Created by JohnY
Special Authority Cholinesterase Inhibitor (CI) DONEPEZIL, GALANTAMINE AND RIVASTIGMINE February 2017
Replaces 2015 version - From JohnY - The new Cholinesterase inhibitor Special Authority form replaces the initial, switching, and renewal eForms! All 3 of the CI eForms were referenced in the general Special Authority eForm. So that one had to be updated too
BC Palliative Care Benefits Registration March 2017
The form has been updated to conform with the latest requisition. It has the SPICT tool to help with filling out the form. It has links to the various government web sites. Built on the 2015 version - Updated November 17th 2015 - signatures improved, button for MD Decision Maker. --- Created using the latest eform generator. Has signature fields, x boxes, links to outside web pages, and a side menu that allows for insertion of the necessary diagnoses. There is a link to the original 3 page fillable pdf so that the instructions can be reviewed. JohnR. Updated Sep23_2017 for Pathways. Minor cosmetic tweaks. Addition of font-size-changer, if you need to squeeze in more details. Dash of colour too! JohnY
Special Authority Filgrastim SA_Filgrastim_V1_Mar29_2018.zip
Requires creation of ANC measurement, and mapping to absolute neutrophil count. May need OSP support to do this. --- To create the measurement and map it look at the tutorial here: http://oscarcanada.org/about-oscar/presentations/measurements-in-oscar/view? The LONIC code for Absolute Neutrophil Count is 751-8
Special Authority Form for ADHD 2018
BC Special Authority form for ADHD medication coverage

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