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Formulary Request Intake Form

This form is to be used for the submission of requests for additions, changes, or considerations related to the Ontario Health atHome Medical Equipment and Supplies (MES) Formulary. Submissions may include requests for new products, product substitutions, or other formulary updates. Information collected through this form supports standardized review and decision-making based on clinical evidence, patient need, supply chain resilience and fiscal responsibility. Completed forms must be submitted to the MESModernization@healthcare.meraksystems.dev for review.