Provider/hospital applies for Interactive Voice Response to verify Health Card numbers via telephone

IHPs requesting approval to submit their claims in MRI format

First Nations clients receiving Ontario Works will fill out this form and mail it to the HSO Program Administrator in order to enroll in the Healthy Smiles Ontario Program.

To help physicians to submit requests for drug funding for their ODB-eligible patients under the Compassionate Review Policy.

Form created with public health. Eligible uninsured patients diagnosed/treated for TB, physicians submit form to get paid

Used by clients/vendors to receive remuneration by direct deposit versus cheque.

Form is generated by client communication system to have people come in to renew photo health card

Used by Mental Health Professional to request Rights Advice for both patient and SDM (if indicated). Form completed when Community Treatment Plan (CTP) and Form 49 are issued by physician. Form, CTP and Form 49 faxed to PPAO.

form completed to obtain approval for dental procedures to be carried out in hospital and covered by OHIP

Used to determine whether a person who is eligible for homemaking and nurses services is required to pay the fees prescribed for the services.

This form is completed by the person in charge of the secure treatment program once the criteria are met for the child's emergency admission to a secure treatment program.

The MedsCheck for Diabetes includes an Annual review that involves using the pharmacist's worksheet and providing the patient with a MedsCheck Personal Medication Record; as well as using a Diabetes Education Checklist and providing the patient with a Diabetes Education Patient Take-Home Summary.

Form is generated by client communication system to have people replace red&white card with photo health card

form placed on top of bundles of primary care forms, to submit to ministry for processing.

To register ESRD patients for Special Drug Program for provision of Eythropoietins.

The application form is for candidates who have either successfully completed the Paramedic training program provided by an approved College or Training Institution or have been considered equivalent through the MOH Standard Paramedic Equivalency Process and wish to write to write the Ministry of Health (MOH) Advanced Emergency Medical Care Assistant (AEMCA) examination.

This application is to enable currently licensed health care professionals to be able to begin submitting or continue to submit claims to the Ministry of Health (the ministry) for insured services. Options include: • Register for an OHIP Billing Number • Register a Health Care Group • Authorize the ministry to make payments to a health care group on your behalf • Update address, banking, and/or group information • Register for Interactive Voice Response (IVR) • Register for the SAV Portal

To facilitate secure and real-time electronic payments for clinical laboratory licences and x-ray facility application fees using debit and credit cards.

he purpose of this form is to collect necessary information to obtain authorized consent and assure identity, under the Freedom of Information and Protection of Privacy Act (FIPPA), for application of services delivered by the Ministry of Health on your behalf (or for a “Health Care Group” in which you are a registered member), including: • Application for an OHIP Billing Number • Changes to Health Care Group Registration Information

This form is to be used by Public Health Units after dental screening to notify parents/guardians that their child has an emergency and/or essential dental condition(s). Parents/Guardian will complete the form and return it to the Public Health Unit to let them know that the child has initiated treatment or to attest to financial hardship and enroll into the Emergency and Essential Services Stream of Healthy Smiles Ontario.