Disability and Health Supports Unit

Request and Justification Forms

The Disability and Health Supports Unit (DHSU) follows current partner program policies and legislation to determine eligibility for medical supply/equipment and diet requests. All requests must be completed by a health professional using the following forms:

Health professionals that may complete the forms are:
  • physicians,
  • registered dieticians,
  • registered physician assistants,
  • registered nurse practitioners,
  • licensed practical nurses,
  • registered nurses,
  • registered midwives,
  • occupational therapists,
  • physical therapists,
  • respiratory therapists, and
  • speech language therapists.

If you require a form to be mailed you, or if have any questions, please contact the DHSU at 204-945-2197 or by email at disandhealthsupports@gov.mb.ca.

For Health Professionals

Health professionals recommending disability or health-related supports for participants in one of the partner programs, may complete and submit the appropriate form:

If you have any questions, please contact staff at the DHSU at 204-945-2197 or 1-877-587-6224 (toll free).