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014-4258-82
Health Card Renewal - ChildForm is generated by client communication system.014-1057-82
(Change of Address form) What's Your Address?Form used to update/change address information of OHIP cardholders014-3324e-53
Appointment of Radiation Protection Officer014-5069-87
Drug Benefit Claim Reversal FormUsed by pharmacies for submitting claims or reversals014-3975-87
Visudyne Therapy Registration/Funding EnrollmentApplication for reimbursement of cost due to use of Visudyne014-1948-95
Application for Direct Bank Payment - ADPUsed by clients/vendors to receive remuneration by direct deposit versus cheque.014-3523-87
Ontario Drug Programs Enrollment Form014-4846-87
Request for Aldurazyme®To facilitate prescribers making reimbursement claims for treatment of Hurler-Scheie and Hurler disease014-3266-54
Application for Reduction of Assessed Co-payment FeesThis form is to be used for a patient who is seeking a reduction to the co-payment or for whom a reduction is sought further to the factors set out in section 10 of Reg. 552 under the Health Insurance Act.
