Manitoba

Manitoba Health

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Manitoba Pharmacare Program

Pharmacare Forms and Worksheets

The Pharmacare form and worksheet below are available for download as PDF documents, for your convenience.

Completed forms and worksheets, and any supporting documentation if required, can be submitted by fax or mail to the address below.

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