Forms

Forms for B.C. Residents


•	Register for Fair PharmaCare Online
•	Fair PharmaCare Registration Form - English^{(PDF 159 Kb)}
•	Fair PharmaCare Registration Form - French^{(PDF 19 Kb)}
•	Fair PharmaCare Consent Form Request
•	Confirmation of Fair PharmaCare Assistance Request
•	Income Review Application


•	Special Authority Request Forms
•	No Charge Psychiatric Medication Program (Plan G) application (for physician/Mental Health Service Centre use)
•	BC Palliative Care Benefits Program Application ^{(PDF 72.3 Kb)}
•	Clinical Services Associated With Prescription Adaptation Agreement — To qualify for payment of clinical services fees, all B.C. pharmacies are required to sign this agreement by March 31, 2009.
•	Frequent Dispensing Authorization^{(PDF 545K)}