Credit grantor must use this form to give a complete accounting of the sale of repossessed goods or collateral to the borrower |
The form is used to provide legal information to applicants of the Manitoba Hepatitis C Assistance Program. This form is completed by the applicant and a witness known to the applicant. This form is processed by Manitoba Health, Seniors & Active Living. |
This application is used to request the transfer of an agricultural lease or permit to an immediate family member, and/or to request the addition of the name of an immediate family member to an agricultural lease or permit.
If you would like to complete this application form, please contact:
Manitoba Agriculture and Resource DevelopmentAgricultural Crown LandsPO Box 128636 Armitage AvenueMinnedosa MB R0J 1E0Office: 204-867-6550Fax: 204-867-6578Email: agcrownlands@gov.mb.caThis form is to be completed when surrendering a lease or permit on agricultural Crown lands or when requesting a name deletion. To obtain the form, contact:
Manitoba Agriculture and Resource DevelopmentAgricultural Crown LandsPO Box 128636 Armitage AvenueMinnedosa MB R0J 1E0Office: 204-867-6550Fax: 204-867-6578Email: agcrownlands@gov.mb.caThis policy is intended for use by Health Authorities to guide their process for purchasing, leasing or otherwise acquiring real property, or an interest in real property.
Last updated: July 11, 2023
The Office of the Manitoba Fairness Commissioner uses this form to record commitments to action by the professional regulatory bodies under the Fair Registration Practices in Regulated Professions Act.
This form is used by Manitoba Health, Seniors and Active Living (the department) staff during a site visit to the addictions agencies which are supported in whole or in part by grants from the department. The form is completed by staff during the visit and outcomes reported to the Executive Director responsible.
This form is applicable to all Manitoba addictions agencies which receive grant funding through continuing service agreements with the department; agreement to submit to site visits by department staff is a condition of the agreements. The form is not public-facing.
This form will be processed by the department of Health, Seniors and Active Living.
This form is designed to provide detailed reporting from Manitoba addictions treatment agencies on the patient population entering their facility. Indicators include intake, referral point, income status, Indigenous status, geographic origin and primary and secondary substances.
This form is applicable to the Manitoba addictions agency supported in full or in part by grants from Manitoba Health, Seniors and Active Living. Requirements to provide this report and others are detailed in the continuing service agreements with the agencies.
This form is processed by the Department of Health, Seniors and Active Living.
This form is completed by Manitoba addictions agencies to provide detailed financial forecasting and quarterly reporting of their budget and expenditures.
This form is applicable to the Manitoba addictions agencies funded in whole or in part by grants from Manitoba Health, through continuing service agreements (service purchase agreements); this financial reporting is required as a condition of the agreements.
This form is processed by Manitoba Health, Seniors and Active Living.A form for ALPs to report on expenditures of approved additional technology and equipment funding |
This form is used to track the movement of patients in personal care homes, whether through the admission of patients into personal care homes, the transfer of patients between personal care homes and the discharge of patients from personal care homes. This form is applicable to Manitoba Health, Seniors and Active Living, the regional health authorities and personal care home facilities. The form is filled out by staff at the personal care homes and processed by Manitoba Health, Seniors and Active Living.
This form is intended to submit admission/discharge information by Provincial and Federal jail facilities, Manitoba Development Centre and Selkirk Mental Health Centre to Manitoba Health to register or cancel provincial health coverage.
This form is for use only by staff of Registration and Client Services and Provincial/Federal Correctional, Manitoba Development Centre and Selkirk Mental Health Centre.
This form is processed by Manitoba Health, Seniors and Active Living.
Adoption Services (Chapter 6) describes provincial standards for adoption and post-adoption services provided under The Adoption Act. The documents outline all aspects of adoption, placement, post placement and repatriation services, including procedures and requirements for applicants seeking to adopt a child in Manitoba.
ALC funding agreement template with terms and conditions |
ALCs prepare revised budgets upon notice of funding amount |
Document to capture information gathered during on-site assessment of ALC |
Application to apply for the bursary for the University of Manitoba Adult Literacy course and instructions on how to have bursary redeemed upon successful completion of the course |
Adult Literacy Program funding agreement template with terms and conditions |
The purpose of this document is to provide information on the Advanced Access training program. This document is applicable to primary care clinics considering taking the training. Manitoba Health, Seniors and Active Living owns and maintains this document.
This form is an application to obtain an aeromedical attendant air emergency medical response licence in the province of Manitoba. This form is applicable to qualified individuals seeking the credential of aeromedical attendant. This form is processed by Manitoba Health, Seniors and Active Living.
This form is an application for currently licenced aeromedical attendant and aeromedical ambulance pilot personnel to renew there air emergency medical response licence. This form is applicable to licensed aeromedical attendant and aeromedical ambulance pilot personnel. This form is processed by Manitoba Health, Seniors and Active Living.
This form is an application to obtain an aeromedical ambulance pilot air emergency medical response licence in the province of Manitoba. This form is applicable to qualified individuals seeking the credential of aeromedical pilot. This form is processed by Manitoba Health, Seniors and Active Living.
This form is an application for currently licenced aeromedical ambulance pilot first officer licence to upgrade to an aeromedical ambulance pilot captain air emergency medical response licence. This form is applicable to licensed aeromedical ambulance pilot first officers. This form is processed by Manitoba Health, Seniors and Active Living.
Municipal Board - Affidavit of Hearing for substitution of subdivision plan.
This policy provides eligibility and subsidy information for the Affordable Foods in Remote Manitoba program. This policy is applicable to participating grocery retailers in designated communities. This Policy is enforced by Manitoba Health, Seniors and Active Living
This form is intended to collect claim information for the Affordable Foods in Remote Manitoba subsidy. This form is applicable to participating grocery retailers in designated communities. This form is processed by Manitoba Health, Seniors and Active Living.
This form is intended to collect application information for the Age Friendly Manitoba Recognition Program. This form is applicable to Municipal Governments. This form is processed by Manitoba Health, Seniors and Active Living.
The Agency Adherence Review form is used to guide an annual review of agency policies and procedures to ensure compliance with standards manuals and other applicable regulations.
The Agency Adherence Review form is used to guide an annual review of agency policies and procedures to ensure compliance with standards manuals and other applicable regulations.
The Agency Adherence Review form is used to guide an annual review of agency policies and procedures to ensure compliance with standards manuals and other applicable regulations.
The Agency Adherence Review form is used to guide an annual review of agency policies and procedures to ensure compliance with standards manuals and other applicable regulations.
The Agency Adherence Review form is used to guide an annual review of agency policies and procedures to ensure compliance with standards manuals and other applicable regulations.
The Agency Adherence Review form is used to guide an annual review of agency policies and procedures to ensure compliance with standards manuals and other applicable regulations.
The Agency Adherence Review form is used to guide an annual review of agency policies and procedures to ensure compliance with standards manuals and other applicable regulations.
The Agency Adherence Review form is used to guide an annual review of agency policies and procedures to ensure compliance with standards manuals and other applicable regulations.
The Agency Adherence Review form is used to guide an annual review of agency policies and procedures to ensure compliance with standards manuals and other applicable regulations.
The Agency Adherence Review form is used to guide an annual review of agency policies and procedures to ensure compliance with standards manuals and other applicable regulations.
Authorization form signed by the registered owner or occupier of Crown Land to authorize disclosure of property assessment information regarding the assessment roll numbers specified on the form.
This is a legal agreement/contract to employ an interprofessional team member. It is applicable to Regional Health Authorities, private primary care clinics and Manitoba Health, Seniors and Active Living. Manitoba Health, Seniors and Active Living processes this form.
This is a legal agreement/contract for a My Health Team. It is applicable to Manitoba Health, Seniors and Active Living, Regional Health Authorities, and participating members from private primary care clinics, community organizations, service delivery organizations. Manitoba Health, Seniors and Active Living processes this form.