Life Saving Drugs Program – Mucopolysaccharidosis type II (MPS II) – Initial application

Treating physicians use this application form to apply for a patient to access LSDP medication for MPS II for the first time, or after a break.

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Life Saving Drugs Program – Mucopolysaccharidosis type II (MPS II) – Initial application

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Publication date:
Publication type:
Form
Audience:
Health sector
Language:
English
Description:

This form includes:

  • information about the application process and timelines
  • treating physician’s responsibilities
  • privacy notice and patient consent
  • health professional details
  • dosing details
  • eligibility requirements and test results
  • treating physician’s declaration
  • application checklist.

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