Forms and Policies
Authorization to Release Information to Manitoba Hepatitis C Assistance Program
| The form is used by applicants to the Manitoba Hepatitis C Assistance Program to authorize Canadian Blood Services to initiate a traceback on any blood/blood products received in Canada and release any and all information to the Manitoba Hepatitis C Assistance Program for the purpose of determining eligibility for compensation. This form is completed by the applicant. This form is processed by Manitoba Health, Seniors & Active Living. |