Below is a link that has the Benefit codes for completion of requests
Medical Supplies and Equipment Guide and Benefit Lists for First Nations and Inuit
The below links are PDF files for the forms corresponding with its name
Medical Supplies Request Form 2025
Exception Drug Request Form 2025
Reformulary – XEOMIN SA Form (Update Feb 2023)
Reformulary – WEZLANA, WEZLANA I.V. SA form (August 2024)
Reformulary – Weight Management Drugs SA form (June 2022)
Reformulary – Ustekinumab Biosimilars SA Form (April 2025)
Reformulary – TEZSPIRE SA form (December 2023)
Reformulary – STELARA SA form (June 2023)
Reformulary – rivaroxaban 2.5 mg (generic) SA Form (Oct 2024)
Reformulary – Rituximab Biosimilars SA Form (February 2023)
Reformulary – RESTASIS, cyclosporine SA Form (December 2020)
Reformulary – REPATHA SA Form (March 2023)
Reformulary – OZEMPIC RYBELSUS SA Form (June 2023) (006)
Reformulary – OCALIVA SA Form (Dec 2020)
Reformulary – Infliximab Biosimilars [AVSOLA, REMDANTRY, RENFLEXIS] SA Form (Mar 2025)
Reformulary – Etanercept Biosimilars SA Form (January 2022)
Reformulary – COSENTYX SA form (September 2024)
Reformulary – BOTOX SA form (January 2022)
