Forms

For physician forms, see the Physicians page

A

Access Card Request Form (Garfield St. only) [WORD]

Advertising Requisition Form [PDF]

C

CIS End User Report Request Form [IIS]

CIS New User Access Request Form [IIS]

CIS User Access Modification Form [IIS]

CIS Request for Change Form [IIS]

Closure Due to Weather Form

D

Development Discussion Checklist [PDF]

Digital File Request Form [PDF]

Direct Deposit Form [PDF]

Dragon DMO Request Form [IIS]

E

Exit Checklist for Supervisors [WORD]

Experienced RN/NP Wage Rate Application 

G

Government ID Application [PDF]

H

Home Care Solution (HCS) – Change Request Form [PDF]

Home Care Solution (HCS) – Data Request Form [PDF]

Home Care Solution (HCS) – User Access Form [PDF]

Home Care Solution (HCS) – User Access Form for External Candidates [PDF]

Human Resource Action Form PDF

I

ICORE Access Request Form [WORD]

In-Province Travel Expense Claim [WORD] (View the Guidelines) [PDF]

Invoice Adjust Distribution Form [PDF]

Invoice Request Form [PDF]

ITSS Internal Forms [IIS]
(eg. Acceptable Use Agreement, New Employee Request, Employee Change Request, VPN, Software Request, etc.)

Item Maintenance Form [PDF]

L

Law Enforcement Disclosure [WORD] 

Leadership Performance & Development Plan [WORD]

Learning and Development Plan [PDF]

Leave of Absence Form [PDF]

Line Sharing Agreement - CUPE [PDF]

Line Sharing Agreement - IUOE [PDF]

Line Sharing Agreement - PEINU [PDF]

Line Sharing Agreement - UPSE [PDF]

Local Purchase Order (LPO) Request Form [PDF]

 

N

New-Hire Checklist for Supervisors [WORD]

O

Oncology Referral Form (PEI Cancer Treatment Centre)

Out-of-Province Travel Authorization and Expense Claim Form [PDF] Instructions and template  [PDF]

Overtime Record [PDF]

P

PEINU Education Fund Committee - Employer Salary Reimbursement Form [PDF]

PSMS Scope/Report Change Request Form [PDF]

Patient and Family Partner Expense Form  [PDF]

Payment Request Form [PDF]

Performance Improvement Plan [PDF]

PEI Cancer Treatment Centre Oncology Referral Form

Photo Release Consent Form [PDF]

Physician forms

Pledge of Confidentiality [PDF]

Position Questionnaire 

Position Management Form (PMF) - Change to an Existing Position [WORD]

Position Management Form (PMF) - New Permanent Position [WORD]

Position Management Form (PMF) - New Temporary Position [WORD]

Position Management Form (PMF) - Position Reclassification [WORD]

Preference for Extra Shifts Form [PDF]

Pre-hire Checklist for Supervisors [WORD]

Printing Requisition - Document Publishing Centre/Queen's Printer [PDF]

Probationary Employee Assessment Form [PDF]

Product/Equipment Performance Form [WORD]

Product/Equipment Standardization Form [PDF]

Public Sector Group Insurance Plan (PSGIP) Complaint Form [PDF]

Public Sector Group Insurance Plan (PSGIP) Dental Claim Form [PDF]

Public Sector Group Insurance Plan (PSGIP) Health Claim Form [PDF]

Public Sector Group Insurance Plan (PSGIP) Out-of-Country Expense Form [PDF]

Purchase Requisition Form [PDF]

Purchasing Single/Sole Source Form [PDF]

R

Reasonable Lateness Request Form [PDF]

Request for Work Orders Form [WORD]

Request to Access or Disclose Personal Health Information (ROI) Form [WORD]English form French form 

S

Signing Authority Request for Delegated Financial Signing Authority [EXCEL]

Signing Authority Request for Delegated Financial Signing Authority - Materials Management and Pharmacy Only [EXCEL]

Site Request Form - Health Care Futures [PDF]

Site Request Form - Nursing Student Summer Employment [PDF]

Storm Form (closure due to weather form)

T

Temporary Assignment Formal Extension [WORD]

U

Uniform Reimbursement Request Form [PDF]

V

Validation of Influenza and/or COVID-19 Immunization Form  [PDF]

Video Release Consent Form [PDF]

 

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