Please complete this form when requesting reimbursement and/or pre-approval of service expenses.
All services are subject to availability of monetary resources.
Please see Member Services for items that REQUIRE authorization from a member of the Manitoba Bleeding Disorders Program (MBDP) treatment team. If this policy applies to this request, please have the appropriate team member contact the Chapter.
PLEASE ALLOW 4 TO 6 WEEKS FOR PROCESSING
Please contact the Chapter office if you have any questions. 204.775.8625 or firstname.lastname@example.org.