Application may only be completed for recipients of ODSP.
The following approved health care professionals licensed to practice in Ontario can complete the application:
• Physicians, Nurse Practitioners, Registered Nurses, Occupational Therapists, Physiotherapists, Physician Assistants, and Psychologists*
*Psychologists can only complete the Medical Transportation section of the form.
The application may only be completed for medical supplies, items, and devices listed in the MSN Schedule of Benefits (
https://www.ontario.ca/page/ontario-disability-support-program-health-and-disability-benefits) and items must not be otherwise reimbursed or subject to reimbursement from any other source.