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014-4420-84
Health Claim -
014-4746-84
Interdisciplinary Health Provider (IHP) Health Number ReleaseForm submitted to ministry to obtain Health Number of patient when not available014-4258-82
Health Card Renewal - ChildForm is generated by client communication system.014-1265-84
Health Number ReleaseHospitals submit form to ministry to obtain Health Number of patient when number is not available014-4297-82
Health Card RenewalForm is generated by client communication system to have people come in to renew photo health card014-4311-82
Health Card Re-RegistrationForm is generated by client communication system to have people replace red&white card with photo health card014-4832-84
Primary Health Care Enrolment Material Order FormPhysicians utilise form to order Primary Health Care select forms/materials from vendor.014-3164-84
Health Card Medical Exemption RequestForm completed to request exemption, i.e., no photo to appear on photo health card014-7026-65
Health Service Organization Information Sheet014-4367-84
Primary Health Care New Patient Declarationform used so that new patient to primary health group can join that group due to reasons on form014-4431-84
Primary Health Care Unattached Patient Declarationform used, in urgent cases (i.e. patient was in hospital, newborn in NICU) where patient has no family physician so can join primary group.014-3384-83
Application for OHIP Billing Number for Health ProfessionalsPhysicians complete form to apply for OHIP billing number and/or specialty billing number.014-4752-84
Undertaking by Interdisciplinary Health Providers (IHP) for Participation in Machine Readable Input (MRI)Form that Interdisciplinary Health Providers will complete and sign agreeing to conform to ministry's technical specifications for claims submission in MRI014-4573-84
Primary Health Care Request to Change Designated Physician - Group EnrolmentUsed by primary care groups who have opted for group enrolment and consent and is only for changing the designated physician of individual patients.014-4751-84
Interdisciplinary Health Provider (IHP) Nurse Practitioner (NP) Authorization for Participation in the NP Service Encounter Reporting and Tracking (SERT) InitiativeForm will be used for NPs to become affiliated with an organization and participate in the NP Service Encounter Tracking and Reporting (SERT) Initiative to receive funding from the MOHLTC014-6430-41
Form 4 - Certificate of Renewal
