Express Scripts Canada Prior Authorization Forms

Express Scripts Canada runs one search for the drug prior authorization forms of the insurers and plan sponsors it manages. Selecting the carrier, group number and province lists the medications that need approval under that plan, with the matching forms. Clinicians meet these when a prescribed drug needs carrier approval before coverage, and the completed form goes to Express Scripts Canada for review.

Who completes it

The patient completes Part A and the prescribing physician completes Part B of the drug-specific form; Express Scripts Canada's page lists these as the first two of three steps.

Submitting and payment

How to submit it
Fax or mail the completed form to Express Scripts Canada Clinical Services in Mississauga, Ontario; the page lists the fax number and mailing address but no online upload.

Good to know

  • Carriers in the search include Cowan Insurance Group, Empire Life, GMS, Groupe Premier Médical, belairdirect, Manion Wilkins and RWAM; each plan's list depends on its group number.
  • Sun Life plan members use a separate Express Scripts Canada site with Sun Life's own prior authorization forms, reached through Sun Life's prior authorization page.
  • Express Scripts Canada notes that coverage eligibility for the drugs listed may vary depending on plan design, so a form being available does not guarantee coverage.
  • The prior authorization page is available in French, and accessible formats of the forms can be requested from Express Scripts Canada.

Get the official form

Download the current version from the source each time; forms change without notice.

Prior Authorization Program

Fill it with Vero

If your copy of the form is a fillable PDF, upload it 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.

How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms change without notice, so download the current version from the official page before you fill it in.

Vero is not affiliated with, or endorsed by, the agencies and insurers listed here. Read our editorial policy.

Frequently asked questions

How do I find a prior authorization form on Express Scripts Canada?

Choose the patient's insurance carrier from the dropdown, type the plan's group number and select the province, then submit. The search returns the medications that require prior authorization under that plan, with the matching forms. Drug name is not a search field, so the group number is essential.

Who fills out an Express Scripts Canada prior authorization form?

The patient completes Part A and the prescribing physician completes Part B. The completed form is then faxed or mailed to Express Scripts Canada. The page says a form must be submitted whenever the prescribed medication requires approval from the patient's insurance carrier before it is covered.

Does the Express Scripts Canada search include Sun Life forms?

No. Sun Life is not among the carriers in the main search. Its prior authorization forms sit on a separate Express Scripts Canada site, reached from Sun Life's prior authorization page, which first asks for the group contract number to confirm the plan includes prior authorization.