All Special Authority eForms

Do Not Use the DOWNLOAD button above. Click on"ATTACHED FILES" above,then download  the individual ZIP files that you need.

Thanks to Gunther Klein for cleaning up the side-menu in the SA Generic eFORM, V37_Jan10_2023.

Thanks to Stan Hurwitz, the 2023 Special Authority form for Empagliflozin/Semaglutide for Diabetes has been added.  This one has wet signature option.

SA_Empagliflozin_Semaglutide_V1_Jan8_2023 - has signature stamp option.

SA_3rd_Line_DM_Meds_V1_Jan8_2023 - replaces the previous 3rd line eFORM, as SGLT2 and GLP1 (injectables at least) are now 2nd line!

SA_COPD eForm updated latest 2022/10/17 background.  SA_COPD_V7_Nov8_2022 - to accommodate the new TripleRx product, Breztri

Updated 2021-Feb-19 16:26 3rd Line DM form changed between October and December of 2020. SA_Generic eForm updated to version 29 to accommodate

Updated January 7th 2021 - new signature script added

Updated December 22th 2020 to accommodate the newest 3rd line DM med eFORM. With content update per HerbC. If a specific one is required, there should be link. Please do not rename, as the links will break. You will have to "delete" (archive) your existing SA generic eFORM to allow this one to zip in.

Updated Dec 17 2020 - new coverage of diabetic medication also requiring new generic form.

Update Jul2020 - another major upgrade needed due to introduction of TWO new eFORMS - for COPD inhalers and ARBs. Some drugs no longer SA - e.g. Plavix. If a drug requires a specific form, you will automatically be shifted to the correct form. If you wish to go back to the main (generic) form, there is a link at the top of each eFORM. For this to work properly, you will need ALL the forms updated. Gotta get them all!

For medication coverage in BC. All other Special Authority eForms are linked to the SA Generic eFORM. This replaces the old Special Authority 2015 eFORM and has been fully updated. A few names are updated, so they will not link with older versions. Most of the names are the same, so if an eFORM does not zip import, please delete/archive the older version with the same name and try again.

SA_Analogue_Insulin is a request to Pharmacare to provide a list of patients who have been prescribed Insulin Lispro (Humalog) or Aspart (NovoRapid).  These insulins will no longer be covered fully, unless switched to their biosimilar products Admelog or Trurapi.

SA_DM_V9_Jan13_2022 - bug fixed that resulted in side warning being printed.

SA_Generic_V33_Apr21_2022.zip - fix broken link to Formulary Search

New SA form for Dapagliflozin for use in HFrEF now available.  Note - this requires additional measurement of LVEF, which may not be available on your system.  It will be evident if the eFORM does not save and you get a red-highlighted pop-up indicating this.  SA_Dapagliflozin_HFrEF_V1_Aug23_2022.zip

Plan P (aka BC Palliative Care Benefits Registration) is in a separate page now.

https://oscargalaxy.org/download/pharmacare-plan-p-bc-palliative-care-benefits-registration/

Plan G (psychiatric medication coverage) has been upgraded and is also on a separate page:

https://oscargalaxy.org/download/pharmacare-plan-g-psychiatric-medication-coverage/