Form submitted to ministry to obtain Health Number of patient when not available

Form used to record hours of physicians in after hours clinics

The ministry is introducing an annual process for patient acknowledgement of professional pharmacy services. This is facilitated with the use of a mandatory form and when completed by the patient confirms the patient's understanding of MedsCheck.

Form allows providers to refer patients for assessment for the program and will be used by hospital sites to record patient eligibility.

This form is completed by Public Health Boards when MOH site is down.

form used for inpatients to Ontario hospitals who are here visiting from other provinces

Hospitals submit form to ministry to obtain Health Number of patient when number is not available

You may use this form if you have applied and are enrolled in the Ontario Seniors Dental Care Program and would like to change the information provided at the time of application. Through this form, you can update applicant information, contact information, marital status and/or spousal information, income declaration, or withdraw consent to disclose personal information and/or personal health information.

Healthy Smiles Ontario Application Through Guarantor form for the core services stream of the program. This form applies to applicants who do not have a valid SIN or have not filed taxes with the CRA, and a guarantor is required to support registration and eligibility adjudication.

The Vendor Registration Application form is an interactive form that will be completed by an Ontario retailer or supplier of home oxygen therapy who is requesting registration with the Assistive Devices Program.

form to be completed by those eligible for eye exams to be covered under OHIP

The information on this form is used to determine eligibility for grant assistance under the Assistive Devices Program.

Application form completed by rehabilitation professionals applying to Underserviced Area Program for financial incentives, in return for filling full-time vacancies in MOHLTC fully-funded positions in Northern Ontario.

Form to be completed by providers on behalf of patients seeking prior approval for insured sex-reassignment surgery.

Form completed by clients to record their wishes for organ/tissue donation

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

Form used so patient can submit out of country medical receipts

Form used by physicians to make inquiries regarding payment details on Remittance Advice

Form outlines the Conformance Testing-Acceptable Use Policy and is part of agreement between ministry and vendor who must successfully pass the conformance testing.

This form is to be used for a patient who is seeking a reduction to the co-payment or for whom a reduction is sought further to the factors set out in section 10 of Reg. 552 under the Health Insurance Act.