Get Canada Gsc Request Form 2012-2025

Filling out the Canada GSC Request Form is an important step for plan members seeking reimbursement for additional dispensing fees associated with compliance packaging. This guide provides clear instructions to help you through the online form-filling process, ensuring that you complete each section accurately.

Follow the steps to successfully complete the Canada GSC Request Form

1. Click the ‘Get Form’ button to obtain the form and open it in your preferred online editor.
2. In Section 1, enter your plan member name and GSC ID number. Indicate how often you would like your medications dispensed (in days) and acknowledge the added costs associated with compliance packaging by signing the form.
3. In Section 2, your pharmacist needs to complete their declaration. They should provide their professional judgment regarding the necessity of compliance packaging, selecting reasons such as multiple chronic medications or physical/cognitive impairments.
4. The pharmacist must then provide supporting information in the space provided, along with their signature, GSC provider number, and pharmacy phone number.
5. Finally, review all sections to ensure completeness. After confirming that all information is accurate, save your changes, and follow the submission instructions to fax the completed form to the designated Green Shield Canada Drug Special Authorization Department.

Complete your Canada GSC Request Form online today to ensure timely processing of your request.