PDF
Word
This version of the form is not currently in use and is provided for reference only. Download this version of
Form HLTH5373
for the current year.
Form HLTH5373 Special Authority Request - Rituximab for Rheumatoid Arthritis - Initial / Renewal - British Columbia, Canada
Form HLTH5373 Special Authority Request - Rituximab for Rheumatoid Arthritis - Initial/Renewal - British Columbia, Canada is a document used to request special authority for the medication Rituximab to treat Rheumatoid Arthritis in the province of British Columbia, Canada. It is used for both initial requests and renewals.
The Form HLTH5373 Special Authority Request - Rituximab for Rheumatoid Arthritis - Initial/Renewal in British Columbia, Canada, is generally filed by healthcare providers or physicians on behalf of their patients.
FAQ
Q: What is the HLTH5373 form?A: The HLTH5373 form is a Special Authority Request form.
Q: What is Rituximab used for?A: Rituximab is used for the treatment of Rheumatoid Arthritis.
Q: Who can submit the HLTH5373 form?A: The HLTH5373 form can be submitted by healthcare providers.
Q: Is the HLTH5373 form specific to British Columbia, Canada?A: Yes, the HLTH5373 form is specific to British Columbia, Canada.
Q: What is the purpose of the HLTH5373 form?A: The HLTH5373 form is used to request Special Authority for Rituximab for Rheumatoid Arthritis, either for the initial treatment or for renewal.
Download Form HLTH5373 Special Authority Request - Rituximab for Rheumatoid Arthritis - Initial / Renewal - British Columbia, Canada
1
2
3
