Drug dosage increase
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Make a change
Use this form to request an increase to a drug dosage outside of Health Canada’s recommended guidelines. You'll find instructions on how to return the completed form on the form itself.
Download the form and print it, or fill it out in Adobe Reader XI or higherOpens a new website in a new window - Opens in a new window (not your browser) and save.
Use this form to request an increase to a drug dosage outside of Health Canada’s recommended guidelines. You'll need your doctor to fill out some sections.