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Provincial Dental Care Program Application Form
2021-09-02
Complete this application to apply for the Provincial Dental Care Program.
Programme de financement des pompes à insuline de l’Î.-P.-É. : Formulaire d’évaluation de la contribution du client ou de la famille et de consentement à la divulgation de renseignements
2021-01-28
Remplissez ce formulaire pour vous inscrire au Programme de financement des pompes à insuline.
Gender Confirming Surgery Prior Approval Request Form
2019-04-17
Gender confirming surgery is insured under PEI Medicare when prior authorization has been obtained from Health PEI. Your family physician or nurse practitioner will need to complete this form and provide the necessary attachments to Health PEI's Out-of-Province Coordinator.
Home Care Referral Form
2019-01-28
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.
Child Audiology Referral Form
2019-01-15
Complete this form to request audiology services for children.
Edinburgh Perinatal/Postnatal Depression Scale (EPDS)
2018-09-26
If you are pregnant and are worried about anxiety or depression, a Public Health Nurse can assist you with completing this Edinburgh Postnatal Depression Scale (EPDS) screening tool for perinatal/postnatal depression and anxiety. Your Public Health Nurse can also provide you with information about...
Formulaire ‒ Directive relative aux soins de santé
2017-04-12
Vous pouvez utiliser ce formulaire pour énoncer vos souhaits ou donner des instructions concernant vos soins et traitements médicaux s’il arrivait qu’un professionnel de la santé détermine que vous êtes incapable de prendre ou de communiquer des décisions au sujet de votre santé.
Dans votre...
Formulaire d'objectifs des soins
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.