Forms

Home Care Referral Form

Published date: May 10, 2024

Complete and submit this referral form to your local Home Care office to access services. A referral can be made by yourself, your family, care provider, or family doctor. Services are provided based on assessed need for a defined period of time.

General Inquiries

Health PEI

PO Box 2000
Charlottetown, PE C1A 7N8

Phone: 902-368-6130
Fax: 902-368-6136

Your Health Privacy

Health PEI Board of Directors

If you are experiencing a medical emergency, call 9-1-1 or go to the nearest emergency department.

If you are unsure what to do about a health issue or if you need health information, 
call 8-1-1.

811 Peace of mind 24/7