Intent to Donate and Language Information

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Consent to organ and/or tissue donation and language profile responses are voluntary and are not required for Health Card eligibility. Personal information on this form is collected under the authority of Section 31(c) of the Freedom of Information and Protection of Privacy Act.

For example C1B 0X1 or 12345
Exemple : 902-555-5555
Please enter the 8-digits from your PEI health card.
You must be 16 or older to apply.