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Healthcare Service Manager Form

Demande d'Accès aux Services en Ligne de la RAMQ SELAT

A downloadable Healthcare Service Manager form for healthcare professionals.
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Specialty

Healthcare Service Manager

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Type

Form

Last edited

7/23/2026

Created by

Heidi Team

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About this form

Designed for public healthcare establishments participating in Quebec’s Assistive Devices Program, this administrative form requests secure access to the SELAT online platform for managing assistive device services. It captures user and establishment information, requested access privileges, authorisation details, and the online applications required, including inventory management, electronic claim submission, account statement consultation, and access to patient assistive device records. The form also records user and authorising manager declarations, supporting secure authentication and compliance with RAMQ access requirements. Heidi helps healthcare organisations efficiently generate structured administrative documentation, reducing manual data entry while supporting secure access to essential online assistive device management services.

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Review and edit

Check the pre-filled details and make any changes before finalising the form.

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Download the completed form or save it directly into your patient records and workflows.

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