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Form/letter for designating visitors from outside of PEI to visit a patient or resident at a Health PEI facility.
To receive a flu vaccination, you must complete a registration form. Complete the top section of this form and bring it with you to a vaccination clinic.
Complete this form to nominate an individual or a team for the Leadership Excellence in Quality and Safety Award.
Your doctor, nurse practitioner or other service provider can refer you for adult services with community mental health and/or addictions services.
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...
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 .
Special authorization request form to be completed by your physician or diagnosing specialist.
Les enfants âgés de 3 à 17 ans dont la famille ne possède, pas, d’assurance dentaire peuvent recevoir des services de traitement dentaire par l’entremise du Programme de soins dentaires pour les enfants (PSDE). Veuillez remplie le present formulaire avant que vos enfants reçoivent des soins...
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.
Your health care provider must complete this form as part of the application process for the Ostomy Supplies Program .