English / French - 014-4573-84b - Primary...
Dataset description:
Used by primary care groups who have opted for group enrolment and consent and is only for changing the designated physician of individual patients.
Source: Primary Health Care Request to Change Designated Physician - Group Enrolment
Additional Information
| Last updated | November 27, 2022 |
|---|---|
| Created | December 11, 2021 |
| Format | application/pdf |
| Form Number | https://forms.mgcs.gov.on.ca/dataset/b3586639-046c-4d48-a0ea-27a751a2b0ad/resource/fdd9a0a7-c330-43af-a3bd-16a3bd5ababf/download/4573-84e.pdf |
| Form File Identifier | 4573-84E |
| Name | English / French - 014-4573-84b - Primary Health Care Request to Change Designated Physician - Group Enrolment |
| Form File Status | Available |
| Description | |
| Language | English / French |
| Functionality | Fill and Print |
| Form File Content Type | Form |
| Remark | |
| Edition Date | 2022-11 |