Form completed to request exemption, i.e., no photo to appear on photo health card
Used to apply for Funding for Pressure Modification Devices
Application for Funding Mobility Devices
Used to apply for Funding for Communication Aids
Used to apply for Funding for Respiratory Equipment & Supplies
Used by Amputee Team, registered with ADP to request funding for conventional upper/lower limb prosthees.
Used to renew funding for home oxygen therapy.
Used to apply for Funding for Ventilator Equipment and Supplies
Application form for drug therapy for Fabry disease
Using the standardized fax template, pharmacists must share the completed MedsCheck Personal Medication Record with the patient's primary prescriber. A record of the successfully transmitted fax must be kept on file at the pharmacy.
Renewal form dor drug therapy for Fabry disease
Application for reimbursement of cost due to use of Visudyne
Public Health Unit requisition for specimen shipping supplies for rabies testing
This is accompaniment to Registration for OHIP & Change of Information forms. Lists acceptable ID documents when applying for Ontario health coverage.
