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Manitoba Health
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Pharmacare Forms and Worksheets
The Pharmacare form and worksheet listed below are available for download as PDF documents, for your convenience.
- The Pharmacare Application and Consent Authorization Form
- The 2009/2010 Pharmacare Projected Income Worksheet
Completed forms and worksheets, and any supporting documentation if required, can be submitted to:
Provincial Drug Programs
300 Carlton Street
Winnipeg MB R3B 3M9
Fax: (204) 786-6634
For more information, please contact: |
| Manitoba Health Provincial Drug Programs 300 Carlton Street Winnipeg, Manitoba R3B 3M9 Phone: (204) 786-7141 Toll free: 1-800-297-8099 FAX: (204) 786-6634 TTY/TDD Relay Service: (204) 774-8618 outside Winnipeg: 711 or 1-800-855-0511 E-mail: pharmacare@gov.mb.ca |
