Autofill Ontario Eap Innohep Request
Request Innohep through the EAP — fill the patient section fast
An EAP request for Innohep (Tinzaparin Sodium) has a patient section and a physician section. This guide is an example of letting hivi fill the patient part so you can hand it to your physician ready for their section.
Official form and source
Start from the official source and always use the current version — form numbers and links can change:
- Service page: Get coverage for prescription drugs — ontario.ca
- Form (Central Forms Repository): EAP Request Innohep (Tinzaparin Sodium) Therapy — 014-4942-87
What this form is about
The EAP Innohep request asks the Exceptional Access Program to approve drug benefit coverage for Tinzaparin Sodium when the patient meets the clinical criteria. The physician justifies the clinical need; the patient section establishes identity.
Before you start: what to gather (patient section)
- The patient's name and Ontario health number.
- The prescribing physician to complete the clinical section.
How hivi makes it faster
- Store the patient details once. Save the name and health number in hivi.
- Autofill the patient section. Use the hivi Chrome extension on a web form, or fill a PDF from the saved profile inside hivi.
- Physician completes the clinical section.
- Submit to the EAP.
Why do it in hivi
The patient details on an EAP Innohep request are identical to those on EAP requests for Lovenox, Fragmin, and other anticoagulants. Stored once in hivi — in Canada, with self-hosted AI — the same patient section fills every related form.