English - 014-3889-84e - Medical Liability...
Dataset description:
Physicians complete form to indicate their preference on how malpractice reimbursement will be sent to them.
Source: Medical Liability Protection (MLP) Reimbursement Program Authorization/ Direct Deposit Request
Additional Information
| Last updated | June 16, 2023 |
|---|---|
| Created | December 11, 2021 |
| Format | application/pdf |
| Form Number | https://forms.mgcs.gov.on.ca/dataset/416d976d-3374-42b2-b6f6-8b2479db97da/resource/27916d7b-ace6-4b19-aaa4-c0612902e26b/download/3889-84e.pdf |
| Form File Identifier | 3889-84E |
| Name | English - 014-3889-84e - Medical Liability Protection (MLP) Reimbursement Program Authorization/ Direct Deposit Request |
| Form File Status | Available |
| Description | |
| Language | English |
| Functionality | Fill and Print |
| Form File Content Type | Form |
| Remark | |
| Edition Date | 2023/04 |