Skip to main content
Important notice

COVID-19 and covered health care

Please refer to the webpage Questions and answers to find out more about covered health care during the pandemic.

Claim Form – Program Regarding Bandages and Compression Garments Used to Treat Lymphedema

Form
Updated on

 13 May 2021

This form is used to apply for a reimbursement of the cost of supplies purchased from a provider that has not signed an agreement with RAMQ. Must be accompanied by the original invoices and proofs of payment, as well as a medical prescription in the case of a first application.

Form 4258

Related topics