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Long Acting Insulin Analogues Special Authorization Request Form

https://www.princeedwardisland.ca/sites/default/files/forms/long_acting_insulin_analogues_special_authorization_request_form.pdf
2018-12-20
Special authorization request form to be completed by your physician or diagnosing specialist.  
SPECIAL AUTHORIZATION REQUEST LONG ACTING INSULIN ANALOGUES Fax requests to (902) 368-4905 OR mail requests to PEI Pharmacare, P.O. Box 2000, Charlottetown, PE, C1A...

PEI Research Ethics Board: Request for Annual Approval

https://www.princeedwardisland.ca/sites/default/files/forms/reb_request_for_annual_approval.pdf
2018-11-08
Every researcher must complete an annual report and request for re-approval.
REQUEST FOR ANNUAL APPROVAL TO: PEI Research Ethics Board DATE: _________________________________ FROM: ______________________________________ Contact Nos. _____________________________ (Principal Investigator or Designate) ADDRESS:...

Edinburgh Perinatal/Postnatal Depression Scale (EPDS)

https://www.princeedwardisland.ca/sites/default/files/forms/edinburgh_perinatal_postnatal_depression_scale.pdf
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...
18HPE43-49634 Edinburgh Perinatal/Postnatal Depression Scale (EPDS) May 2018 Edinburgh Perinatal/Postnatal Depression Scale (EPDS) Name: ___________________________ Personal Health #:______________ Date: _________________ Age of...

Demande de carte Santé Î.-P.-É.

https://www.princeedwardisland.ca/sites/default/files/forms/pei_health_card_application_form.pdf
2018-08-30
Vous n’avez qu’à remplir une demande de carte santé et la soumettre à Santé Î.-P.-É. Sans carte, vous devrez payer pour recevoir des services hospitaliers et médicaux.
Personal Health Card Application • Carte santé personnelle Formulaire de demande PO Box 3000 126 Douses Road, Montague Prince Edward Island, C0A 1R0 Canada Telephone: (902) 838-0900 / 1-800-321-5492 Please print all...

Psoriatic Arthritis Special Authorization Request Form

https://www.princeedwardisland.ca/sites/default/files/forms/psoriatic_arthritis_special_authorization_request_form.pdf
2018-04-19
Special authorization request form to be completed by your physician or diagnosing specialist.  
SPECIAL AUTHORIZATION REQUEST PSORIATIC ARTHRITIS Fax requests to (902) 368-4905 OR mail requests to PEI Pharmacare, P.O. Box 2000, Charlottetown, PE, C1A 7N8...

Demande de présentation au conseil d’administration de Santé Î.-P.-É.

https://www.princeedwardisland.ca/sites/default/files/forms/demande_de_presentation_au_conseil_dadministration_de_sante_i.-p.-e.pdf
2018-03-27
Les personnes ou les groupes qui souhaitent faire une présentation au conseil d’administration de Santé Î.-P.-É. doivent remplir et soumettre le présent formulaire, trois semaines (21 jours) avant la réunion du conseil, .
Microsoft Word - Public Participation Form Final.docx Request to Present to the Health PEI Board of Directors Persons or groups who wish to present to Health PEI Board of Directors must complete and submit this form three weeks (21 days) in...

Routine Obstetrical Ultrasound Disclosure/Consent Statement

https://www.princeedwardisland.ca/sites/default/files/forms/routine_obstetrical_ultrasound_disclosure_consent_statement.pdf
2018-02-12
Read and sign this disclosure/consent statement if you wish to know the sex of your baby during your  second or third trimester ultrasound.
Microsoft Word - Routine Obstetrical Ultrasound Finalized Disclosure_1_2.docx   Q44‐01 (06/12)    Routine Obstetrical Ultrasound Disclosure/Consent Statement During the routine second or third trimester ultrasound, if the patient (mother)...

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