Formulaire d'Autorisation de Retour d'Équipement de Mobilité RAMQ
About this form
Simplify mobility equipment return requests with Heidi by automatically completing the Demande d’autorisation – Retour d’un fauteuil roulant ou d’une base de positionnement au fournisseur form for the Régie de l’assurance maladie du Québec (RAMQ). Designed for authorised assistive technology services and rehabilitation centres, this administrative form supports requests to return manual or powered wheelchairs and positioning bases to the supplier. It captures patient and establishment information, details of the mobility device being returned, including the model, serial number, delivery date, and purchase order transmission date, as well as supporting comments and the reason for the return. The form also records the responsible service representative’s certification and facilitates RAMQ authorisation of the return request. Heidi helps authorised providers efficiently generate structured administrative documentation, reducing manual data entry while supporting accurate equipment lifecycle management and compliance with RAMQ program requirements.
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