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014-4956-64
Healthy Smiles Ontario – Change of InformationHealthy Smiles Ontario Change of Information form is a paper form submitted by mail as a result of a change during any benefit year. This form is used to add or change information about the applicant, marital status and/or spouse, and children/youth. This form is only required for those who have applied and been enrolled in the core services stream of the program.014-4473e-67
Prior Testing Disclosure - Manual WheelchairThis form is used by Manufacturer's Testing Facilities to report testing of Manual Wheelchairs.3977-84
Health Care Provider Claim - Diagnostic and Treatment ServicesForm created with public health. Eligible uninsured patients diagnosed/treated for TB, physicians submit form to get paid014-4744-84
IHP Application for Direct Bank PaymentForm used by IHPs to set up direct bank deposit014-4367-84
Primary Health Care New Patient Declarationform used so that new patient to primary health group can join that group due to reasons on form014-4474e-67
Prior Testing Disclosure - Powered Mobility DevicesThis form is used by Manufacturers to report testing of Powered Mobility Devices014-4316-84
Patient Enrolment Batch Headerform placed on top of bundles of primary care forms, to submit to ministry for processing.014-5068-39
Health and Well-Being Grant Program Statement of InterestStatement of Interest application form for the Health and Well-Being Grant Program014-1565-95
Assistive Devices Program Confirmation of Payment InstructionsThe form is an application for direct bank deposit for vendors registered with the Assistive Devices Program.014-4478-84
Adjustmentonline form to be available to providers and to Regional Operations staff on a permanent basis on the internet014-0022-84
OHIP Group Registration for Health Care ProfessionalsForm used by physicians to register with group014-0864-84
Authorization for Group PaymentForm completed by provider authorizing payment to go to group014-4550-88
Application for Tuition Support Program for NursesApplication form completed by nursing candidates to apply to Tuition Support Program for Nurses for financial incentives.014-4746-84
Interdisciplinary Health Provider (IHP) Health Number ReleaseForm submitted to ministry to obtain Health Number of patient when not available4975-47
MedsCheck Patient Acknowledgement of Professional Pharmacy ServiceThe 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.014-7158-84
In-Patient Standard Ward Costsform used for inpatients to Ontario hospitals who are here visiting from other provinces014-1265-84
Health Number ReleaseHospitals submit form to ministry to obtain Health Number of patient when number is not availableon00704
2024 Physician Assistant (PA) Career Start- CONTACT, RECRUITMENT AND FINANCIAL (CRF) FORMThe form collects contact, recruitment and financial information from applicants who have successfully recruited PA graduates.on00703
2024 Physician Assistant (PA) Career Start Grant Application FormThe Application form collects information from employers to determine their eligibility for funding through the PA Career Start Program.014-5050-67
Vendor Registration Application - Home Oxygen TherapyThe 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.