Newfoundland and Labrador Department of Health and Community Services Forms

This form is used for reporting cases of Invasive Group A Streptococcal Disease (Streptococcus Pyogenes) in Newfoundland and Labrador, Canada.

This document is an Appendix IV Case Report Form specifically for reporting hospitalizations, deaths, and serious adverse events in the context of healthcare in Newfoundland and Labrador, Canada.

This document is for the Long Term Care and Community Support Program in Newfoundland and Labrador, Canada. It is used for conducting an adult needs reassessment for individuals who require long-term care and community support services.

This form is used to request the release of the MCP (Medical Care Plan) number for a beneficiary in Newfoundland and Labrador, Canada.

This document is an application form specifically for residents of Newfoundland and Labrador, Canada, who are applying for out-of-province coverage. It is used to request a certificate that provides coverage for medical services received outside of the province.

This form is used for applying to dental programs in Newfoundland and Labrador, Canada. It gathers information about the applicant's personal and academic background, as well as their experience in the field of dentistry.

This document is a request form for reimbursement for the Adult Dental Program in Newfoundland and Labrador, Canada. It allows eligible individuals to seek reimbursement for dental expenses covered under the program.

This document is used for assigning the payment agreement in Newfoundland and Labrador, Canada.

This document is a request for approval to temporarily bill for services on a fee-for-service basis by a salaried physician in Newfoundland and Labrador, Canada.

This document is an application form for the 65plus Plan, which is available for landed immigrants residing in Newfoundland and Labrador, Canada.

This document is an application form for the Newfoundland and Labrador Prescription Drug Program (NLPDP) in Canada. It is used to apply for coverage for prescription drugs in the province of Newfoundland and Labrador.

This document provides information on the continuation of coverage for rheumatoid arthritis medications in Newfoundland and Labrador, Canada.

This document is a special authorization request form for the medication Ticagrelor (Brilinta) in the province of Newfoundland and Labrador, Canada. It is used to request approval for coverage of this medication under certain circumstances.

This type of document is for registering the birth or adoption of newborns and children in Newfoundland and Labrador, Canada. (French version)

This document is used for requesting a certificate of coverage outside the province in Newfoundland and Labrador, Canada.

This Form is used for submitting healthcare claims for residents of Newfoundland and Labrador who received medical treatment outside of the province. It is used to request reimbursement for eligible expenses incurred while receiving medical care in another Canadian province or territory.

This document is used to request information on the medical claims history of an individual in Newfoundland and Labrador, Canada. It is commonly used by insurance companies and healthcare providers to gather relevant information for assessing claims and determining coverage.

This document is for accessing and managing electronic billing in Newfoundland and Labrador, Canada. It provides a convenient method for receiving and organizing bills electronically.

This form is used for obtaining consent from individuals in Newfoundland and Labrador, Canada to release their personal information for the purposes of the Prescription Drug Program.

This Form is used for requesting treatment for Idiopathic Pulmonary Fibrosis in Newfoundland and Labrador, Canada.

This form is used for requesting special authorization for biologic therapy for the treatment of inflammatory bowel disease in Newfoundland and Labrador, Canada.

This Form is used for requesting special authorization for Levemir (Insulin Detemir) in Newfoundland and Labrador, Canada.

This form is used to request special authorization for daily dispensing of methadone maintenance treatment in Newfoundland and Labrador, Canada.

This Form is used for requesting special authorization to initiate coverage for restricted rheumatoid arthritis medications in Newfoundland and Labrador, Canada.

This form is used for requesting special authorization for take-home doses of Methadone Maintenance Treatment in Newfoundland and Labrador, Canada.

This Form is used for requesting special authorization for the medication Sevelamer (Renagel) in the province of Newfoundland and Labrador, Canada.

This form is used for obtaining the first certificate of involuntary admission in Newfoundland and Labrador, Canada.

This form is used for requesting coverage of blood glucose test strips in Newfoundland and Labrador, Canada.

This Form is used for applying for a Certificate of Renewal in Newfoundland and Labrador, Canada.

This form is used for notifying a person in Newfoundland and Labrador, Canada that a Community Treatment Order is no longer in effect.

This document is used for ordering the apprehension and transportation of an involuntary patient who has taken unauthorized leave in Newfoundland and Labrador, Canada.

This Form is used for obtaining an Authorized Patient Pass in Newfoundland and Labrador, Canada.