he purpose of this form is to collect necessary information to obtain authorized consent and assure identity, under the Freedom of Information and Protection of Privacy Act (FIPPA), for application of services delivered by the Ministry of Health on your behalf (or for a “Health Care Group” in which you are a registered member), including:
• Application for an OHIP Billing Number
• Changes to Health Care Group Registration Information
The "Low-Volume Claim Submission Claim File Generator" is a tool that allows registered Health Care Professionals/Registered Third-Party Billing Agencies (RTPBAs) to generate a claim file that can be securely submitted to the ministry electronically for the purpose of payment.
Form to request approval for patient to receive surgery In-Province.
For physicians and patients to apply for the Inherited Metabolic Disorders (IMD) Program.
Used to apply for Funding for Enteral Feeding Pump and Supplies
The information on this form is used to determine eligibility for grant assistance under the Assistive Devices Program.
Form is used to register new or returning Ontario residents or renew photo Health Card and contains instructions/information.
For retailers that primarily sell vapour products to apply for a specialty vape store registration.
Used by clients/vendors to receive remuneration by direct deposit versus cheque.
Form outlines the Conformance Testing-Acceptable Use Policy and is part of agreement between ministry and vendor who must successfully pass the conformance testing.
Consent Form for the Inherited Metabolic Diseases (IMD) Program
form sent to other provinces for reimbursement of inpatient claims paid (reciprocal)
This form is completed by the person in charge of the secure treatment program once the criteria are met for the child's emergency admission to a secure treatment program.
