To provide patient advocacy groups with a template for written submissions to the ministry on a drug; the form is to make sure all the appropriate information is provided.
To allow patient advocacy groups to register into the database so that they provide written submissions to the ministry on a drug; the form is to make sure all the appropriate information is provided.
Used to apply for Funding for Pressure Modification Devices
Application for Funding Mobility Devices
Used to apply for Funding for Communication Aids
Used to apply for Funding for Respiratory Equipment & Supplies
Used by Amputee Team, registered with ADP to request funding for conventional upper/lower limb prosthees.
Statement of Expense for Health Care Providers and Allied Health Care Professionals.
For retailers that primarily sell specialty tobacco products to apply for a tobacconist registration.
Used to request a change in vendor for an approved Assistive Devices Program claim
Transfer of ownership of Integrated Community Health Services Centre (ICHSC) licence.
Used to renew funding for home oxygen therapy.
Used to apply for Funding for Ventilator Equipment and Supplies
Application form for drug therapy for Fabry disease
Using the standardized fax template, pharmacists must share the completed MedsCheck Personal Medication Record with the patient's primary prescriber. A record of the successfully transmitted fax must be kept on file at the pharmacy.
