Registration and Renewal Forms
For applicants who do not have a permanent address (applicant currently resides in a shelter, hostel, or similar institution.)
For applicants with a permanent residential address and (a) responsible individual(s) and/or (b) who are having their product shipped to their health care practitioner.
Changes to a non-residential address (a shelter, hostel, or similar institution).
Paper forms can be sent to Broken Coast at: Box 1150, Ladysmith, BC, V9G1A8
*Please mail via Canada Post. Couriers such as FedEx and UPS cannot deliver to PO boxes.