How to request Fragmin through the Ontario Exceptional Access Program — and autofill it with my-id.ca
Request Fragmin through the EAP — fill the patient section fast
An EAP request for Fragmin (Dalteparin Sodium) has a patient section and a physician section. This guide is an example of letting my-id.ca fill the patient part quickly.
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 Fragmin (Dalteparin Sodium) Therapy — 014-4941-87
What this form is about
The EAP request for Fragmin asks the Exceptional Access Program to approve drug benefit coverage when the clinical criteria are met. The patient section identifies the individual; the physician provides the clinical justification.
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 my-id.ca makes it faster
- Store the patient details once. Save the name and health number in my-id.ca.
- Autofill the patient section. Use the my-id.ca Chrome extension on a web form, or fill a PDF from the saved profile inside my-id.ca.
- Physician completes the clinical section.
- Submit to the EAP.
Why do it in my-id.ca
The same patient details appear on every EAP form — for Fragmin, Lovenox, Innohep, and other EAP drugs. Stored once in my-id.ca — in Canada, with self-hosted AI — the patient section fills itself each time.
Frequently asked questions
- What does the EAP Fragmin request ask for?
- The patient's name and Ontario health number, plus clinical justification from the prescribing physician. my-id.ca stores patient details so the patient section can be autofilled.
- Can my-id.ca complete the physician section?
- No — the prescribing physician must complete the clinical section. my-id.ca only autofills the patient details.
- Where is it submitted?
- To the Ministry of Health's Exceptional Access Program. Confirm the current process on ontario.ca.
Fill it once. Reuse it everywhere.
Save your information in my-id.ca once, then autofill this form and the next one — web forms with the Chrome extension, PDFs right in the app. Your data is stored in Canada and AI runs on my-id.ca's own servers, never sent to third-party AI providers.