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Manitoba Child and Family Services Personal Health Information Request Form
This form is intended to request information or services of the Registration and Client Services department by employees of Manitoba Child and Family Services agencies. This form is for use only by staff of Registration and Client Services and Manitoba Child and Family Services. This form is processed by Manitoba Health, Seniors and Active Living.
Department/Crown:Health
Category:Health
Manitoba Civil Service Commission Right of Election Form
This formed is used by claimants, who are Manitoba Civil Service Commission employees, to elect to receive sick benefits from the Province of Manitoba sick leave benefit plan and assign their Income Replacement Indemnity (IRI) payments to the Province of Manitoba, or to receive sick benefits during the seven-day waiting period only and then collect IRI. 
Department/Crown:Manitoba Public Insurance
Manitoba Environmental Farm Plan: Workbook
The Manitoba Environmental Farm Plan (EFP) workbook helps farmers to assess and identify the environmental assets and risks on their  farm operations, and develop an action plan to address identified risks. Farmers must attend a facilitated workshop to receive an EFP Workbook.
Department/Crown:Agriculture
Category:Agriculture
Manitoba Health Adverse Storage Condition (ASC) Form and Procedure
This form is used for notifying Manitoba Health, Seniors and Active Living in the event that publicly-funded vaccines and biologics are exposed to an exposure outside of the manufacturers recommended storage conditions. This form is applicable to physicians, nurses, pharmacists and other health professionals providing immunization services.  This form is processed by Manitoba Health, Seniors and Active Living.
Category:Health
Manitoba Health External Access Coordinators

This form is intended to manage the user access process by departments or facilities that access Manitoba Health's information systems. This form is applicable to all regional health authorities, CancerCare Manitoba, the Addictions Foundation of Manitoba, Selkirk Mental Health Centre and other publicly funded health care agencies/organizations requesting/requiring user access. This form is processed by Manitoba Health, Seniors and Active Living.

Department/Crown:Health
Categories:Application, Health, Healthy Living
Manitoba Health External Agencies Grant Accountability

This policy is to provide formalized directions for Manitoba Health toward the goal of accountability in administration of its External Service Providers grants funding and to ensure that granting practices are consistent with the Accountability Framework and Grant and Other Funding guidelines provided by Internal Audit and Consulting Services of Manitoba. This policy is applicable to Manitoba Health and its External Service Providers. This policy is enforced by Manitoba Health, Seniors and Active Living.

Department/Crown:Health
Categories:Financial Assistance, Health, Healthy Living
Manitoba Health Vaccines and Biologics Order Form
This form is used for ordering vaccines and biologics from the Provincial Distribution Warehouse. This form is applicable to physicians, nurses, pharmacists and other health professionals providing immunization services. This form is processed by Manitoba Health, Seniors and Active Living.
Category:Health
Manitoba Hepatitis C Compassionate Assistance Program (MHCAP)

This policy describes the requirements of the Manitoba Hepatitis C Compassionate Assistance Program.  This policy is applicable to Manitobans who became infected with Hepatitis C (HCV) after receiving a transfusion of blood or blood products before Jan 1, 1986 or between July 1, 1990 and September 28, 1998.  This policy is enforced by Manitoba Health, Seniors and Active Living.

Department/Crown:Health
Category:Health
Manitoba Key Worker Check-in/Exit Form
This form is completed at the 6 month, 18 month, and exit stages of the program. It collects information on current services/supports, caregiver work attendance, caregiver understanding of FASD, caregiver stress levels, family outcomes and satisfaction with the program; and their child's school attendance.
Department/Crown:Families
Manitoba Key Worker Closure Policy
This policy establishes the extent of service provided to families within the program and provides staff with procedures to help them guide families towards self sufficiency.
Department/Crown:Families
Manitoba Key Worker Follow-Up Form
This form is completed 3 months after a family has exited the program. It collects information on current services/supports, caregiver work attendance, and if the family has been in contact with their Key Worker since exiting the program.
Department/Crown:Families
Manitoba Key Worker Intake Policy
This policy assists staff to respond to requests for service and referrals to the program, as well as requests for presentations on FASD from the community.
Department/Crown:Families
Manitoba Key Worker PES
A survey collecting information on the family's perceived ability to interact with service systems, parent organizations, and the services their child and family receive.
Department/Crown:Families
Manitoba Key Worker Welcome Form
This form collects background information on the family and their child, family connection to services/supports, caregiver work attendance, caregiver understanding of FASD and stress levels; and their child's school attendance.
Department/Crown:Families
Manitoba Maternal Serum Screen

This form is for Manitoba Maternal Serum Screen requisition from the Cadham Provincial Laboratory. This form is applicable to health practitioners on behalf of the public. This form is processed by Cadham Provincial Laboratory.

Department/Crown:Health
Category:Health
Manitoba Monitored Drug List

The Manitoba Monitored Drug List is a list of drugs or classes of drugs specified in the Manitoba Drug Benefits Formulary and designated as monitored drugs.

Effective date of transition from Regulation to Policy: October 18, 2021.

Department/Crown:Health
Category:Health
Manitoba Pediatric Insulin Pump Program
This policy provides direction to the Winnipeg Regional Health Authority to establish pediatric insulin pump access through the Winnipeg Regional Health Authority.  This policy is applicable to eligible Manitoba children and adolescents less than 18 years of age. This policy is enforced by Manitoba Health, Seniors and Active Living and the Winnipeg Regional Health Authority.

Department/Crown:Health
Category:Health
Manitoba Pharmacare Program

This policy describes the application requirements to access eligible drugs under the Specified Drug Regulation and Manitoba Drug Benefits Interchangeability Formulary at no cost once the family unit's income-based deductible is satisfied.  This policy is applicable to eligible Manitobans who do not have their drug costs paid for through another government program. This policy is enforced by Manitoba Health, Seniors and Active Living.

Department/Crown:Health
Category:Health
Manitoba Post-Adoption Services Adult Adoptee Application

This application is for adult adoptees (18+ years of age) to apply for post-adoption services. Post-Adoption Services include requesting birth documents, requesting a non-identifying Social History and registering for contact with and search services for birth family members.

Department/Crown:Families
Category:Families
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