Class action against tobacco companies

If you need the Health Insurance Number of a tobacco victim, you must file a request for access to information for a deceased person. Find out more

Application for Reimbursement – External Breastforms Program

Form

Updated on

26 March 2024

This form is used to apply for a reimbursement of the cost of breastforms purchased in Québec.

To find out more, refer to the page External breastforms.

Form 3198

Download (.pdf)
150.39 KB

Protection of your personal information
In order to offer you certain services, we need to collect, use, and sometimes disclose your personal information. To find out more about our privacy practices on our website, please refer to our Privacy policy webpage.