Overhead Stipend Survey

Please fill out the following questions.

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* 1. Name

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* 3. Business Address

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* 4. What is your primary payment modality?

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* 5. Are you responsible for overhead costs of physical space for a facility not covered by Health PEI? (Proof may be required by MSPEI, Health PEI or our auditors)

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* 6. Are you responsible for staff compensation for non-Health PEI employees? (Proof may be required by MSPEI, Health PEI or our auditors)

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* 7. Are you compensated or subsidized for your overhead expenses by Health PEI or the Government?

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* 8. I agree that MSPEI will review my FFS billings provided by Health PEI to confirm I meet the $100,000 threshold for eligibility.

Thank you for submitting your application. Submission of an application does not guarantee approval of the benefit. All applications will be reviewed after the submission period closes, and applicants will be contacted in the fall once the review process is complete.

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