This form 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.
The ICHSC Program must be notified of a change in quality assurance advisor through the submission of the Quality Assurance Advisor form which must be signed by both the centre’s quality assurance advisor and the licensee.
Used by clients/vendors to receive remuneration by direct deposit versus cheque.
Application used to determine eligibility for funding by ADP for Hearing Devices.
Used to apply for Funding for Visual Aids
The form is an application for direct bank deposit for vendors registered with the Assistive Devices Program.
Application for drug funding
Requisition for Naloxone
Authorizer Application - Attachment B
