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Goals of Care Form
2016-11-23
The Goals of Care form is used by your health care provider after speaking with you and your substitute decision maker. These instructions that will guide your health care team about the general focus of your care and where you might want that care. Your health care provider will write your Goals...
Blood Glucose Record - Travelling Across Time Zones
2016-04-21
Use this to record your blood glucose levels while you are travelling across time zones.
Blood Glucose Record - 24 Hour
2016-04-21
Use this to record your blood glucose levels over a 24 hour period.
FIT Home Screening Test Request Form
https://www.princeedwardisland.ca/sites/default/files/forms/fit_home_screening_test_request_form.pdf
2016-03-03
Complete this FIT Home Screening Test Request form if you are, 50-74 years of age, and are of, average risk for colorectal cancer, .
Adult Audiology Case History Form
2016-01-07
Complete this form to provide information on your hearing and submit with your Audlt Audiology Referral Form.
Child Audiology Case History Form
2016-01-07
Complete this form to provide information on your child's hearing and submit with your Child Audiology Referral Form.
Eye See...Eye Learn Co-pay Reimbursement Application
2016-01-07
Complete and submit an application for co-pay reimbursement for the Eye See... Eye Learn program if your optometrist is unable to bill your insurance provider directly. You will have to pay up front and be reimbursed for the remaining amount.
Eye See...Eye Learn Program Declaration
2016-01-07
Complete the Eye See... Eye Learn Program Declaration if you do not have private insurance. Your optometrist will not ask you to pay for the exam and glasses, if required, as they are covered by Health PEI and the PEI Association of Optometrists.
Orthodontic Treatment Funding for Cleft Palate Patients Application Form
2016-01-07
Complete this form to apply for orthodontic treatment funding for children who are born with cleft palate. Depending on your family income and number of children in the family, funding will cover 50, 75 or 100 per cent of the cost of orthodontic treatment provided by an orthodontist in Prince...