Universal Influenza Immunization Program Reimbursement Form for influenza immunization clinics that are eligible for reimbursement through the Universal Influenza Immunization Program.
Universal Influenza Immunization Program Pharmacy Form for influenza immunization clinics that are eligible for reimbursement through the Universal Influenza Immunization Program.
Consent Form for the Inherited Metabolic Diseases (IMD) Program
Used for the determination of applicant's available monthly income.
Calculation of Chronic Care Co-Payments for use by hospital staff, patients, and families.
The Seniors Co-Payment Program Application is available on the Ontario Drug Benefit Program Online Applications and Forms website:
https://forms.ontariodrugbenefit.ca/.
If you are not able to complete the form online, please contact the SCP at 416-503-4586 (Toronto area) or 1-888-405-0405 (outside Toronto) for a paper version of this form.
The Trillium Drug Program Application is available on the Ontario Drug Benefit Program Online Applications and Forms website:
https://forms.ontariodrugbenefit.ca/.
If you are not able to complete the form online, please contact the TDP at 416-642-3038 (Toronto area) or 1-800-575-5386 (outside Toronto) for a paper version of this form.