Get Fi Application For Reimbursement Status And Wholesale Price For A Clinical Nutritional Preparation 2020-2025

The FI Application For Reimbursement Status And Wholesale Price For A Clinical Nutritional Preparation is an essential document for seeking approval and pricing details of clinical nutritional products. This guide offers clear, step-by-step instructions to help users fill out the application effectively and accurately online.

Follow the steps to successfully complete your application online.

1. Click ‘Get Form’ button to obtain the form and access it in the editor.
2. Begin by filling in the applicant's details. This includes entering the applicant's name, business ID, and contact information such as postal address, telephone number, fax, and email address.
3. In the product section, enter the name of the clinical nutritional product, its dosage form, manufacturer, importer, and package size.
4. Under the wholesale price section, input the valid confirmed wholesale price, and propose a new wholesale price, if applicable, detailing these amounts in euros.
5. Select the type of application you are submitting: either for reimbursement status and wholesale price or a wholesale price increase. Indicate any relevant diseases under the Government Decree that relate to the reimbursement status.
6. Provide a comprehensive list of application appendices, which should include justifications for reimbursement status, expected sales estimates, product specifications, and pricing comparisons with other EEA states.
7. Fill out the invoicing section with the invoicing address and relevant contact details.
8. Confirm your consent to the terms mentioned regarding unprotected email communication from the Pharmaceuticals Pricing Board.
9. Finally, sign and date the document. Ensure that you clarify your name in the space provided for the clarification of signature.
10. Once all fields are complete, users may save their changes, download the form for printing, or share it as needed.

Complete your application online today for timely processing.