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Displaying 1 - 10 of 263 records for "forms"
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PEI Pharmacare Forms
2024-04-02
For Medical Professionals
Ankylosing Spondylitis Special Authorization Request Form [PDF | 113 KB]
Crohn's Disease Special Authorization Request Form [PDF | 190 KB]
DPP-4 / SGLT2 Inhibitors Special Authorization Request Form [PDF | 190 KB]
Enfuvirtide Special Authorization Request Form [PDF |...
Emergency Medical Technician (EMT) Verification of Registration Form
2019-07-10
Complete this form to verify your registration with the appropriate regulatory body. Send forms to each regulatory body where registered and/or licensed currently or previously. Additional copies of this form must be used if you have been registered in more than one province/territory.
Glucose Sensor Program Initial Application Form
2024-05-06
Use this form to enroll in the Glucose Sensor Program.
To enroll in both the Insulin Pump Program and the Glucose Sensor Program use Insulin Pump Program or Insulin Pump Program plus Glucose Sensor Program Initial Application Form.
Insulin Pump Program and Glucose Sensor Program Renewal Form
2024-04-25
Use this form to renew your enrolment in the Insulin Pump Program or both the Insulin Pump Program and the Glucose Sensor Program together.
To renew your benefits for only the Glucose Sensor Program, use the Glucose Sensor Program Renewal Form instead.
Adults Immunization Schedule (for use by Health Care Providers)
2023-12-13
Why do adults need immunization?
Adults may need immunizations for a number of reasons including:
to provide a booster against waning immunity, e.g. tetanus;
to protect against diseases more common in adults, e.g. herpes zoster;
to protect those who may be too young or too vulnerable to be...
COVID-19 Vaccine Order Form for Vaccine Providers
2023-03-28
Public and private sector health care providers authorized to order a supply of the COVID-19 vaccines from the PEI Chief Public Health Office will be issued an access code to complete the online form below. Any health care service administering the COVID-19 vaccine in PEI must comply to the COVID-...
Emergency Medical Technician (EMT) Emergency Call-Out Form
2019-01-07
Complete this form for all emergency call-outs.
Emergency Medical Technician (EMT) National Licensing Examination Registration Form
2019-01-07
Complete this form to register for EMT National Licensing exams.
Rheumatoid Arthritis Special Authorization Request Form
2024-04-18
Special authorization request form to be completed by your physician or diagnosing specialist.