Forms and Brochures
- General Forms
- Client Forms
- Quantity and Frequency Review (QFR) Forms
- Replacement Request Forms
- Authorizer Forms
- Vendor Forms
- Wheelchair Benefit Applications
- Benefit Assessment Tools
- Brochures
General Forms
Client Forms
Effective January 1, 2009, Alberta Health Care will no longer be collecting premiums. Consequently, AADL has changed the process of determining cost-share exemption.
In order to administer this new process, AADL will need to collect Social Insurance Numbers (SIN’s) for those clients applying for Cost-Share Exemption with our Program. Your SIN number will be shared with the Canada Revenue Agency (CRA) under the information sharing terms of a Memorandum of Understanding agreement with CRA. CRA will then release back to us the information on Line 260 of the tax file so that we can determine eligibility for the exemption.
If you have any questions about this process, please call AADL at 780-427-0731
(Toll free at 310-0000, then, when prompted, 780-427-0731.)
Temporary Cost-Share Exemption- Cost-Share Exemption Appeal
- Complaint
- Client Declaration Form
- Change of Vendor Request
Quantity and Frequency Review (QFR) Forms
- QFR Request Form
- Quantity & Frequency Appeal to Director
- Quantity and Frequency Review Request for Disposable Supplies
- Quantity and Frequency Request for Intermittent Catheter Supplies
Replacement Request Forms
- Wheelchair Cushion Replacement Request (Scrap)
- Wheelchair Cushion Replacement Request (Client)
- Manual Wheelchair Replacement Request
Authorizer Forms
- Authorizer Application
(Updated October 26, 2009)
- Authorizer Interactive Voice Response Guide
Vendor Forms
- Vendor Application
- Vendor Interactive Voice Response Guide
- Compression Stocking Vendors’ Fitting Form
- AADL Specialty Suppliers Breast Prosthesis Fitter’s Form
Wheelchair Benefit Applications
- Adult Power Wheelchair Application
- Pediatric Power Wheelchair Application
- Pediatric Tilt-in-Space Request
Benefit Assessment Tools
- Compression Stockings Assessment Tool
- Adult Incontinence Assessment Tools and Bladder Diary
- Pediatric Incontinence Assessment Tool
- Readiness for Toilet Training Assessment Tool
- Wheelchair Cushion Assessment Tool
- Manual Wheelchair Assessment Tool
- Braden Pressure Ulcer Risk Assessment Tool
Brochures
- AADL General Information Brochure
- Mastectomy Benefits Brochure
- Pediatric Incontinence Brochure
- Urinary Incontinence Brochure
- Cost-Share Exemption Appeal Information Sheet
- Compression Stockings Brochure
Distinct but Linked Brochure - Government Services for Pre-School Children with Special Needs
