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.

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.

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.

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.

This policy outlines the tariff codes that may be submitted by Registered Nurse Extended Practice for activity and outcome tracking purposes to Manitoba Health, Seniors and Active Living. This policy is applicable to nurses who have achieved the designation of Registered Nurse Extended Practice and will be submitting claims to Manitoba Health, Seniors and Active Living for services rendered. This policy is enforced by Manitoba Health, Seniors and Active Living.

This policy regulates workers and patient's exposure to radiation as well as preventing general public's exposure to regulation. This policy is applicable to all relevant medical equipment that emit radiation and clinicians who use them. This policy is enforced by CancerCare Manitoba.

This form is for supplies 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.

This policy is applicable to all health authorities and provides direction regarding expectations for Health Authority policies and protocols related to Medical Assistance in Dying, congruent with Federal legislation.  This policy is enforced by Manitoba Health, Seniors and Active Living.  

This form is an application for agencies to become licensed in the province of Manitoba so they can provide non-transporting medical first response services. This form is applicable to qualified agencies that wish to provide non-transporting medical first responder service. This form is processed by Manitoba Health, Seniors and Active Living.

This form is an application for agencies to renew their emergency medical service licence in the province of Manitoba so they can provide non-transporting medical first response services. This form is applicable to qualified agencies that wish to continue to provide non-transporting medical first responder service. This form is processed by Manitoba Health, Seniors and Active Living.

 This is a return of service contract for medical students / residents participating in the Medical Students/Residents Financial Assistance Program - Northern/Remote Family Medicine Residency Stream (NRFMRS) and International Medical Graduate (IMG Program Combined Agreement 2016). The contract outlines the obligations of the parties, namely MHSAL, the University of Manitoba and the medical student/resident with respect to the program.

This policy outlines the process for regions to obtain reimbursement of costs associated with the dispensing of medications for meningococcal post-exposure prophylaxis. This policy is applicable to physicians, nurses and other health professionals working in public health, primary care, specialty care, community health, and infection prevention and control. This policy is enforced by Manitoba Health, Seniors and Active Living.

This form is an application to the Selkirk Mental Health Centre to cover the cost of attending the Mental Health First Aid Workshop they provide by demonstrating an explanation how this education would help you provide assistance to someone you know that is struggling with mental health problems. This form is available to the general public and external agencies including the Regional Health Authorities of Manitoba. This form is enforced by Mental Health Commission of Canada and Selkirk Mental Health Centre.

This form for use to appeal the following other types of decisions:

• decisions made by a regional health authority assessment panel regarding an application for personal care in a personal care home;
• decisions related to a request for approval to operate a laboratory or a specimen collection centre or the conditions imposed on an approval, or the revocation of an approval;
• decisions related to licenses to operate a personal care home or the suspension or cancellation of licences;  
• decisions made under The Emergency Medical Response and Stretcher Transportation Act related to licenses to operate an emergency medical response system or stretcher transportation service or the suspension or cancellation of licenses.

This document lists some examples of the type of information that may be

This form is for use to appeal the following decisions related to Home Care services, if the matter cannot be resolved with the Home Care program:

• an application for Home Care service is denied
• disagreement with the type of service that has been approved
• disagreement with the level of service that has been approved

This form is filled out by members of the public, specifically Manitobans who have applied for or are receiving Home Care. The form is processed by the Manitoba Health Appeal Board.

This form is for use to appeal decisions made by Manitoba Health, Seniors and Active Living regarding the assessed daily rate charged to individuals residing in long-term health care facilities (for example, hospitals, personal care homes).  This form is filled out by members of the public. This form is processed by the Manitoba Health Appeal Board.

This form is for use to appeal decisions made by Manitoba Health, Seniors and Active Living in relation to persons who are refused registration as an insured person or denied a benefit under The Health Services Insurance Act and regulations made under the Act (for example, out-of-province medical services, plastic surgery, travel subsidies).  This form is filled out by membersญญญญญญญญญญ the public. This form is processed by the Manitoba Health Appeal Board.

This guideline outlines the minimum standards for the operation of a MFSE in the area of food safety and sanitation and should be used as a supplement to The Food and Food Handling Establishments Regulation. This guide is applicable to all Mobile Food Service Establishments (not to push carts or mobile food units that return to a commissary each day) and must be approved and permitted by a Public Health Inspector prior to operating. Health, Seniors and Active Living enforces the guidelines.

This document is to be completed by an active My Health Team to submit their Service Plan. This form is applicable toญญญญญญญญญญญ members of an operational My Health Team including individuals from of private primary care clinics, community organizations, service delivery organizations. Manitoba Health, Seniors and Active Living processes this form.

The purpose of this form is for a My Health Team to plan the second My Health priority (timely access and complex patients). This form is applicable toญญญญญญญญญญญ members of a My Health Team including individuals from private primary care clinics, Regional Health Authorities, community organizations and service delivery organizations. Manitoba Health, Seniors and Active Living processes this form.

The purpose of this form is to document a service plan budget for the My Health Team. This form is applicable toญญญญญญญญญญญ members of a My Health Team including individuals from private primary care clinics, Regional Health Authorities, community organizations and service delivery organizations. Manitoba Health, Seniors and Active Living processes this form.

This form is used to list the next of kin for Selkirk Mental Health Centre patients. This form is available to Selkirk Mental Health Centre patients, patients' family and staff. This form is enforced by the Selkirk Mental Health Centre.

This policy manual sets the parameters of the Northern Patient Transportation Program (NPTP) for subsidizing medical transportation costs for qualifying Manitoba residents.  This policy is applicable to Regional Health Authorities and the public. This policy is enforced by Regional Health Authorities.

This policy describes the requirements of the Tiered Biologics Reimbursement Policy in Manitoba.  This policy is applicable to all biologics prescribers.  This policy is enforced by Manitoba Health, Seniors and Active Living.

This form is intended to notify Registration and Client Services staff of changes to existing registration files by persons covered by Manitoba Health.

This form is applicable to members of the public.

This form is processed by Manitoba Health, Seniors and Active Living.

This form is used to notify personal care home residents and their families/representatives of the residential/authorized charge assessed by Manitoba Health, Seniors and Active Living.  The form is applicable to personal care home facilities and those residents applying for a reduced residential charge and theirfamilies/representatives.  The form is filled out by the personal carehome facility.

This policy provides support to efforts related to the recruitment of nurses in Manitoba through the Nurses Recruitment and Retention Fund by authorizing the use of funding to reimburse nurses for certain authorized expenses related to relocating to Manitoba. The policy indicates rules of eligibility for reimbursement and the responsibilities of the parties. This policy is enforced by Manitoba Health, Seniors and Active Living.

This is an application form for funding from the Nurses Recruitment and Retention Fund in exchange for a 12-month return of service commitment under the conditional grant program. The form was last updated in May 2021.

This is an application form for funding from the Nurses Recruitment and Retention Fund in exchange for a 12-month return of service commitment under the Registered Nurse, Registered Psychiatric Nurse and Licensed Practical Refresher Program.

This policy is intended to assist NRRF in addressing issues of nursing supply by supporting the allocation of funding for a return of service program that is available to nurses who wish to practice in personal care homes. This policy is enforced by Manitoba Health, Seniors and Active Living.

This form is an application for submitting courses for optional credit for the Manitoba Continuing Competency Program for Paramedics. This form is applicable to members of the public. This form is processed by Manitoba Health, Seniors and Active Living.

This online application is intended to allow report of changes of address on Manitoba Health cards by existing Manitoba Health card holders to the Registration and Client Services Department.

This form is applicable to members of the public.

This form is processed by Manitoba Health, Seniors and Active Living.

This policy pertains to Orders from Non-EMS Affiliated Physicians.  This policy is applicable to licensed paramedics and service providers. This policy is enforced by Manitoba Health, Seniors and Active Living.

The Out of Province Transportation Subsidies Regulation permits reimbursement of transpotation costs in accordance with the regulation.

The purpose of the Out-of-Province Travel Subsidy Claim Form is to provide insured Manitoba residents, who have received the prior approval of Manitoba Health, Seniors and Active Living to receive medical care outside of Manitoba.

This form is maintained by Manitoba Health, Seniors and Active Living.

This policy is the patient care map on Pre-arrival Notification of Stroke Facilities within the WRHA.  This policy is applicable to licensed Paramedics.  This policy is enforced by Manitoba Health, Seniors and Active Living.

This policy is the patient care map on Acute Coronary Syndrome. This policy is applicable tolicensed Paramedics. This policy is enforced by Manitoba Health, Seniors and Active Living.

This policy is the patient care map on Bypass for STEMI Primary Response (Code-STEMI).  This policy is applicable to licensed Paramedics.  This policy is enforced by Manitoba Health, Seniors and Active Living.

This policy is the patient care map on Acute Stroke.  This policy is applicable to licensed Paramedics.  This policy is enforced by Manitoba Health, Seniors and Active Living.

This policy is the patient care map on Amphetamine-Type Stimulant Psychosis.  This policy is applicable to licensed Paramedics.  This policy is enforced by Manitoba Health, Seniors and Active Living.

This policy is the patient care map on Bypass and Non-referred IFT to a Stroke Center.  This policy is applicable to licensed Paramedics.  This policy is enforced by Manitoba Health, Seniors and Active Living.

This policy is the patient care map on Transport to the Comprehensive Stroke Center (HSC).  This policy is applicable to licensed Paramedics.  This policy is enforced by Manitoba Health, Seniors and Active Living.

This policy is the patient care map on Transport to a Stroke Treatment Site.  This policy is applicable to licensed Paramedics.  This policy is enforced by Manitoba Health, Seniors and Active Living.

This policy is the patient care map on Standard Destination for Primary Response.  This policy is applicable to licensed Paramedics.  This policy is enforced by Manitoba Health, Seniors and Active Living.

This policy pertains to the administration of the medication Olanzapine for Methamphetamine Psychosis.  This policy is applicable to licensed Paramedics.  This policy is enforced by Manitoba Health, Seniors and Active Living.

This policy pertains to the administration of the medication Acetylsalicylic Acid (ASA).  This policy is applicable to licensed Paramedics.  This policy is enforced by Manitoba Health, Seniors and Active Living.

This policy pertains to the administration of the medication Ticagrelor.  This policy is applicable to licensed Paramedics.  This policy is enforced by Manitoba Health, Seniors and Active Living.

The purpose of this form is to gather data to inform discussions at Primary Care Capacity Planning meetings. This form applies to primary care staff within the Regional Health Authorities. Manitoba Health, Seniors and Active Living staff process this form.

The purpose of this form is to document a service plan budget for the My Health Team. This form is applicable toญญญญญญญญญญญ members of a My Health Team including individuals from private primary care clinics, Regional Health Authorities, community organizations and service delivery organizations. Manitoba Health, Seniors and Active Living processes this form.

This policy is intended to assist NRRF in addressing issues of nursing supply by supporting the allocation of funding for a return of service program that is available to nurses who wish to practice in personal care homes. This policy is enforced by Manitoba Health, Seniors and Active Living.

This information manual is used by Manitoba Health, Seniors and Active Living to provide information on the residential charges rate determination process, rate reduction and review processes, appeal process and waiver process.  In addition, the information manual provides an overview of the residential charge policies applied by Manitoba Health, Seniors and Active Living.  The information manual is applicable to Manitoba Health, Seniors and Active Living, other departments within the Provincial government, the Regional Health Authorities, personal care home facilities, residents of personal care home facilities and their families/representatives and the general public.  The information manual is updated on an annual basis by Manitoba Health, Seniors and Active Living.

This form is an application to obtain a land emergency medical response personnel licence in the province of Manitoba. This form is applicable to qualified individuals seeking a licence to practice as EMS personnel. This form is processed by Manitoba Health, Seniors and Active Living.

This form is an application for currently licenced land emergency medical response personnel to renew a land emergency medical response licence. This form is applicable to licensed land emergency medical response personnel. This form is processed by Manitoba Health, Seniors and Active Living.