If you qualify for reimbursement for the FreeStyle Libre or FreeStyle Libre 2 flash glucose monitoring systems, you must submit by mail a completed PEI Glucose Sensor Program Initial Family Contribution Assessment and Release of Information form (PDF 356 kB) to the Glucose Sensor Program Administrator, Health PEI, 16 Garfield Street, Charlottetown, PE, C1A6A5. In subsequent years you can renew either online or via paper form.
The form can be downloaded and printed from the website or copies are available at local PEI¶ Diabetes Education Centres.
Within this initial application form, there is a one-page Special Authorization document that requires completion by your medical practitioner, nurse practitioner or diabetes educator.
Please consult the Prince Edward Island (PEI) Provincial Diabetes Program website for additional details.
¶ Those eligible for reimbursement in Prince Edward Island must be 4 years of age or older, be taking three or more daily injections of insulin or using an insulin pump, and must be enrolled in the Diabetes Glucose Sensor Program.