-
For Specialist physician & ADP registered authorizer to request funding for intraoral (mouth) prostheses.
-
Used to apply for Funding for Respiratory Equipment & Supplies
-
Used by clients to apply for funding for a silicone breast prosthesis(es)
-
Used by Amputee Team, registered with ADP to request funding for conventional upper/lower limb prosthees.
-
Application used by Homemaker and Nurses to request reimbursement from the Province for services provided.
-
-
-
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
-
Used to renew funding for rtCGM
-
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.
-
-
-
-
Renewal form dor drug therapy for Fabry disease
-
