Required: Most Up-to-date Adobe Reader Software
The device used to access the eForm must have the current Adobe Reader installed
If using old version, download the latest version of Adobe Acrobat. A free version of the software is all that is required.
NOTE: You may see this when you try to open the PCPCM Application Form:
Be sure to download the Form, save it to your desktop and open it in the Adobe Acrobat application. It will not open in an alternative PDF reader.
Still Experiencing Issues?
Watch our Instructional video and explore the FAQ with additional support for Mac & PC users.
- Download the Form attachment and save it to your desktop.
- Via your desktop or Finder window, double-click or control-click to open with Adobe. If Preview is your system's default PDF reader, the file will not open. Please ensure you have the most up-to-date version of Adobe Reader on your Mac and select "Open with Adobe"
- Use Adobe to fill in the required fields
Type directly in the form and choose from the drop downs as appropriate.
eForms are "smart forms" that display new fields according to previously entered information. Please type all required information into the form and review for completeness. - When complete, click Save. Adobe will automatically save the completed form to the same folder, overriding the original file. You can also Choose a Different Folder to save both copies.
- Attach the completed form to your email and follow the application instructions.
You may also choose to click the SUBMIT button on the form. If it works correctly, it will autogenerate an email with the completed form attached using your email software.
*Additional help resources for Mac users available via Adobe
- Save the Form to your Computer
Move your cursor over the form, right click, select Save (target / link) As, choose folder on computer, name and save. - Open the saved Form
Navigate to the folder on your computer where the document was saved and right click, Open With- Adobe from there.
- Work directly in the Form
The PCPCM Application form will open for completion, type directly on the form and choose from the drop downs as appropriate.
eForms are PDF smart forms that will display new fields according to previously entered information. Please type all required information into the form and review for completeness before printing for authorization.
- When complete, click Save. Adobe will automatically save the completed form to the same folder, overriding the original file. You can also Choose a Different Folder to save both copies.
- Attach the completed form to your email and follow the application instructions.
You may also choose to click the SUBMIT button on the form. If it works correctly, it will autogenerate an email with the completed form attached using your email software.
TIP: It is recommended you save the eForm using Adobe Reader after completing it in case changes are required at a later time.
*Additional help resources for PC users available via Adobe
Yes, physicians can enrol in the PCPCM at any time. Information on deadlines and corresponding start dates can be found on the March 24 Alberta Government Bulletin.
You will receive an email from the Alberta Medical Association with a copy of the Ministerial Order for your records and the PCPCM application form PCN14743 Rev. 2025-02.
Please follow the steps in this email and submit the requested information back to Alberta Health.
After your application is received you will have notification of submission emailed to you from Alberta Health.
You will receive an email from Alberta Health indicating the date your application was received. Applications will be forwarded for processing. Once generated, a letter will be mailed out to you containing your PCPCM Business Arrangement number.
The AMA does not have up to date information on application status and processing. Alberta Health will send a ‘Confirmation of Application’ receipt to the physician after the application has been reviewed. It is expected to have a couple days delay.
The copy of the Ministerial Order you received as a secondary attachment titled MO50_2025 PCPCM Feb 20 2025 3.pdf is for your personal records and does not require filling out.
The PCPCM Clinic ARP Attestation/ Declaration required for Alberta Health’s records is on form PCN14743 Rev. 2025-02 Section D of the PCPCM - Application attachment as seen below:
The Ministerial Order defines "off-loading" as shifting care for paneled patients to fee-for-service physicians when the primary physician could have reasonably provided that care. The key consideration here is what is reasonable in the given context.
For example, having a locum available for same-day, more urgent visits seems reasonable. However, if a locum is routinely seeing the same overflow patients, it may be important to assess whether panel size and demand are impacting access.
Please ensure you have the most up to date version of the application form (PCN14743 Rev. 2025-02 in the bottom left corner of the document.)
A number of physicians have reached out with challenges. Please see this troubleshooting resource How to use PCPCM PDF Forms
Please ensure you are filling out the correct version of the application form sent via email on or after 10 p.m. February 24, 2025. This is the most up to date version. It will have the form number PCN14743 Rev. 2025-02 in the bottom left of the document.
If you are having difficulty entering text to certain fields the appropriate check box above the area may not have been selected.
This opens the text fields to be edited.
Or you may be trying to fill out the Ministerial Order copy intended for your personal records and need to open the form PCN14743 Rev. 2025-02.
You will need to attach a void cheque or official banking direct deposit documentation.
We have been informed that the embedded features in Adobe, such as the ability to attach within the document are not always consistent.
We encourage you to attach the completed document and VOID cheque/ Banking documents to an email and send to health
If you have multiple email addresses, it is important that you use the email address linked to your AMA Member Dashboard to submit your PCPCM application to Alberta Health. That email address was used to verify eligibility and would have received the documents you need for your application submission. Applications received from alternate email addresses will be sent back for resubmission.
Please submit your application to health
Please do not cc the PCPCM inbox in this email.
The Submitter ULI and Submitter Prefix Code are provided by H-Link, to physicians, or the person/organization who submits claims on their behalf. The Submitter ULI is a 9-digit number that is different from your Prac ID number. The Submitter Prefix Code contains three alpha-characters. This identifier is attached to your billing and claims documentation, you will likely find your Submitter Prefix on your Statement of Assessment documentation.
Claims are submitted electronically using H-Link electronic claims system
Here is the Physician Resource Guide with additional information on Alberta Health’s website.
If you still can’t locate this information you may want to reach out to H-Link, or your accredited submitter attached to your Fee- for Service Business Arrangement.
If a physician wants their payment sent to the clinic, they can check either the ‘Practitioner’ or ‘Professional Corporation’ box under Section C. If the physician has a Prof Corp, include the legal name. Include the banking information for the clinic below. This does not need to match the banking information on your Prof Corp. It is advisable for clinics to contact an accountant that has a good understanding of their specific structure for further advice.
If you are not able to attach the void cheque or official bank deposit documentation to the PDF, Alberta Health has advised that physicians send the void cheque or financial institution documentation in a separate email to health
The Practitioner Identification number is a unique nine-digit code, assigned by Alberta Health to individual practitioners. This number can be found on your Statement of Assessment or in your EMR provider configuration details.
Please use this resource to locate your Facility ID | AMA in your EMR. You can submit your WDFA as an alternative. This information is located in your Netcare “My Details”
Please use this resource to find your CPAR Panel ID | AMA . Alternatively, you can contact your CII/CPAR Panel Administrator for assistance.
As the majority of clinics currently using Connect Care are on an annualized funding model, it has not been configured for PCPCM. For questions, please contact health