Below are the documents to be filled out to register for the above-mentioned program. To register, you must fill out two separate forms:
The registration form can be filled out by anyone who is directly involved in the disabled person’s care (relative, respondent, tutor, worker, or the disabled person themselves). This person must identify themselves and sign the form in the space provided.
All the requested information must be provided. Don’t forget to attach the medical diagnosis to your form.
A different plan must be filled out for each treatment site. This form must be filled out by a responsible professional at the CISSS where you receive treatment.
The treatment period must be between April 1 and March 31 of the following year.
The information provided must reflect the disabled person’s situation.
Once all the documents have been duly completed, you must return them as soon as possible to the following address:
Transport et hébergement des personnes handicapées
CISSS de la Montérégie-Centre (territoire Champlain—Charles-Le Moyne)
3120, boulevard Taschereau, Greenfield Park (Québec) J4V 2H1
To contact us:
Telephone: 450-928-6777, ext. 13553
Once your file is complete, we will analyze your request and notify you as to your eligibility for the program.
If your application for financial assistance is given priority, we will let you know which trips are authorized and how to obtain your reimbursement.
You will need to submit the following document with your claim (one copy per site).
Note that registration in the program does not constitute an authorization, and that no reimbursement will be granted for expenses incurred without the written authorization of the CISSS de la Montérégie-Centre (Champlain—Charles-Le Moyne territory).
P.S. You can also consult the framework program by clicking here: Framework program