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.

Contact

If you require a form to be mailed you, or if you have any questions, please contact us.

 

Alternate Format Requests

For alternate format requests, please contact the Department of Families Accessibility Coordinator:

Department of Families Accessibility Coordinator
205–114 Garry Street,Winnipeg MB, R3C 4V4
Phone: 204-945-3469
E- mail: fswebunit@gov.mb.ca