Formulaires

Shelley L. Woods Excellence in Person Centered-Care Award - Nomination Form

2017-08-23

The Shelley L. Woods Excellence in Person-Centered Care Award recognizes a Health PEI employee working in long-term care who demonstrates an exceptional commitment to person-centred care philosophy.  Complete this form to nominate a Health PEI employee working in a long-term care facility.

Request to Review Driver's License

Sécurité routière
2017-08-16

Out-of-Province Travel Declaration Form

Régime d'assurance-médicaments
2017-08-10

PEI Pharmacare clients travelling outside of the province may be allowed to obtain up to 180 days of their eligible medication prior to leaving the province. If your medication is eligible, complete this form prior to leaving the province and take it to your pharmacy, so they can keep it on file. Learn more about the PEI Pharmacare Travel Supply Policy.
 

Recalculation Office Filing Information Registration Form (fillable)

Section du droit familial
2017-08-10

The Administrative Recalculation Office recalculates child support payments. Either parent must file an application form and send it, with an attached copy of the order/agreement containing the recalculation clause to the Administrative Recalculation Office. This is a fillable .doc version of the form. 

Maintenance Enforcement Program Registration Application Form (fillable)

Section du droit familial
2017-08-10

Application for Maintenance Enforcement Program registration (fillable .docx file)

LFS Monthly data file

Économie, statistiques et relations financières fédérales
2017-08-04

Supporting data file for the monthly release of the Labour Force Survey.

Pulmonary Rehab Referral Form

Soins primaires et maladies chroniques
2017-08-02

Your physician or nurse practitioner can refer you to the Pulmonary Rehab Program by submitting this referral form. If you meet the inclusion criteria for the program, you will be contacted for an assessment appointment.

For more information, visit the Cardiac and Pulmonary Rehab Programs.
 

Cardiac Rehab Referral Form

Soins primaires et maladies chroniques
2017-08-02

Your physician or nurse practitioner can refer you to the Cardiac Rehab Program by submitting this referral form. An exercise stress test must be sent in with your referral. If you meet the inclusion criteria for the program, you will be contacted for an assessment appointment.

For more information, visit the Cardiac and Pulmonary Rehab Programs.
 

Seniors Health and Wellness Strategy Advisory Network Application

Politiques et programmes en matière de santé
2017-07-31

This is an application form for membership on the Seniors Health and Wellness Strategy Advisory Network.