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This version of the form is not currently in use and is provided for reference only. Download this version of
Form HLTH5469
for the current year.
Form HLTH5469 Special Authority Request - Dalteparin / Tinzaparin / Enoxaparin (Biosimilar) for Treatment of Venous Thromboembolism in Cancer Patients - British Columbia, Canada
Form HLTH5469 Special Authority Request - Dalteparin/Tinzaparin/Enoxaparin (Biosimilar) for Treatment of Venous Thromboembolism in Cancer Patients - British Columbia, Canada is used to request special authorization for the use of Dalteparin, Tinzaparin, or Enoxaparin (Biosimilar) as a treatment for Venous Thromboembolism in cancer patients in British Columbia, Canada.
The form HLTH5469 Special Authority Request - Dalteparin/Tinzaparin/Enoxaparin (Biosimilar) for Treatment of Venous Thromboembolism in Cancer Patients in British Columbia, Canada is typically filed by healthcare providers or doctors.
FAQ
Q: What is the purpose of the HLTH5469 Special Authority Request form?A: The HLTH5469 Special Authority Request form is used for requesting Dalteparin, Tinzaparin, or Enoxaparin (Biosimilar) for the treatment of Venous Thromboembolism in Cancer Patients.
Q: Who is eligible to use the HLTH5469 Special Authority Request form?A: The HLTH5469 Special Authority Request form is used by healthcare professionals in British Columbia, Canada.
Q: Which medications can be requested using the HLTH5469 Special Authority Request form?A: The HLTH5469 Special Authority Request form can be used to request Dalteparin, Tinzaparin, or Enoxaparin (Biosimilar) for the treatment of Venous Thromboembolism in Cancer Patients.
Q: What is Venous Thromboembolism?A: Venous Thromboembolism refers to blood clots that form in the veins, usually in the legs, and can potentially travel to the lungs.
Q: Who are considered as Cancer Patients in this context?A: In this context, Cancer Patients refer to individuals diagnosed with cancer who are at risk of developing Venous Thromboembolism.
Q: What is Special Authority?A: Special Authority is a process wherein certain medications are approved for coverage by the government in specific situations or conditions.
Q: Can healthcare professionals from other provinces use this form?A: No, the HLTH5469 Special Authority Request form is specifically for healthcare professionals in British Columbia, Canada.
