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Community Mental Health and Addictions - Adult Services Referral Form
2019-11-12
Your doctor, nurse practitioner or other service provider can refer you for adult services with community mental health and/or addictions services.
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.