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Express Scripts Canada fax number

(905) 712-6329

Clinical Services

Used for: Submitting Prior Authorization requests for prescription drug benefits; PA requests are reviewed and decided (approved/denied) by Express Scripts Canada.

Fax destination details

Department
Clinical Services
Purpose
Submitting Prior Authorization requests for prescription drug benefits; PA requests are reviewed and decided (approved/denied) by Express Scripts Canada.
Form
Prior Authorization Form — Prior Authorization Form / Request for Prior Authorization
Address
2915 Argentia Road, Unit 7, Mississauga, ON L5N 8G6

Before you send

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  • Check the organization website or call its main line for the current fax number.
  • Include a cover sheet and any case, member, claim, or form reference required.
  • Keep the delivery confirmation with your submission records.

Plan member completes Part A, prescribing physician completes Part B, then fax or mail the completed form to Express Scripts Canada Clinical Services for review.

Review official form instructions

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