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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...

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...

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...

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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