Québec prescribers use this request when a drug listed in Annex IV of the Liste des médicaments needs RAMQ payment authorization and no exception-drug code fits the patient. More than 40% of exception drugs are codified, so a code on the prescription often replaces the request. When it doesn't, RAMQ checks the justification against the drug's recognized indications for payment.
An authorized prescriber completes the whole form: insured person, prescriber with RAMQ registration number, the drug requested, the justification and diagnosis, then signs it. In the online service, the prescriber can delegate entry to administrative or nursing staff once RAMQ grants them access.
Download the current version from the source each time; forms change without notice.
Demande d'autorisation de paiement – Médicament d'exception
Request for Payment Authorization – Exception Drug
Upload the fillable PDF once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.
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No. For many exception drugs, codification replaces the payment authorization request: you write the code matching the patient's recognized indication on the prescription, and coverage is confirmed without delay. Use a code only when it matches the patient's situation. The online service shows each drug's code and indications when you start a new request.
RAMQ publishes form 3633 in French only. The online service Patient et médicaments d'exception is RAMQ's main channel for these requests, and the PDF is meant for prescribers without access or with technical problems. Prescribers outside Québec who haven't joined Québec's health insurance plan use form 4515 instead.
RAMQ commits to answering a complete priority exception-drug request within 1 business day and any other complete request within 25 business days, although some files need complex processing. Incomplete requests take longer, so include every required supporting document. The decision arrives in the prescriber's secure messaging.