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014-4885-84
Change of Address for Health Care Professionals -
014-4832-84
Primary Health Care Enrolment Material Order FormPhysicians utilise form to order Primary Health Care select forms/materials from vendor.014-4367-84
Primary Health Care New Patient Declarationform used so that new patient to primary health group can join that group due to reasons on form014-0022-84
OHIP Group Registration for Health Care ProfessionalsForm used by physicians to register with group3977-84
Health Care Provider Claim - Diagnostic and Treatment ServicesForm created with public health. Eligible uninsured patients diagnosed/treated for TB, physicians submit form to get paid014-4431-84
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.014-5056-87
Information Available to Health Care Providers through the Digital Health Drug Repository“The Digital Health Drug Repository (DHDR) Reference Guide may be used by health care providers to understand the inclusions and limitations of the information available through the DHDR.”016-on00139
Application for Employment Occupational Health and Safety Inspector - Health CareApplication for Employment to be used in the upcoming Health Care Health & Safety Inspector recruitment for the Ministry of Labour. Applicants will download the form from the Ministry of Labour website and complete the application in order to apply for an Industrial inspector position.014-4573-84
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.014-7698-84
Application for OHIP Direct Bank Payment for Health Care Professionalsform used so physicians can have direct deposit of payment of claims014-3264-54
Hospital Chronic Care Co-payment FormCalculation of Chronic Care Co-Payments for use by hospital staff, patients, and families.045-4767-69-lhin
Application for Determination of Eligibility for Long-Term Care Home Admission (Ontario Health atHome)To be filled out by long-term care (LTC) home applicants as part of the process for determination of eligibility for admission to a LTC home. This completed form is for use by Ontario Health atHome, as the designated placement co-ordinators for long-term care homes, as per the Fixing Long-Term Care Act, 2021, s 47(1).045-4768-69e
Health Assessment - Ontario Health atHomePLEASE NOTE: The Health Assessment Form has been updated as of July 7th, 2025. Practitioners are asked to begin using the new form immediately. However, assessments completed using the old form will be accepted by Ontario Health atHome until December 31st, 2025. This form is to be used for completion of the assessment required under the Fixing Long-Term Care Act, 2021 when a person applies for a determination of eligibility for long-term care home admission. The required assessment is of the applicant’s physical and mental health, and the applicant’s requirements for medical treatment and health care. This assessment must be made by a physician or registered nurse.
