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form to be completed by those eligible for eye exams to be covered under OHIP
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Used by clients to request funding assistance for Insulin Pumps and Supplies for Children
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The information on this form is used to determine eligibility for grant assistance under the Assistive Devices Program.
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Used by clients/vendors to receive remuneration by direct deposit versus cheque.
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To facilitate prescribers making reimbursement claims for treatment of Hurler-Scheie and Hurler disease
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Form used by IHPs to set up direct bank deposit
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Used to determine whether a person who is eligible for homemaking and nurses services is required to pay the fees prescribed for the services.
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This 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.
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form used so that new patient to primary health group can join that group due to reasons on form
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Form used as part of EDT registration package for IHPs
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IHPs apply to submit claim information via EDT
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Used by primary care groups who have opted for group enrolment and consent and is only for changing the designated physician of individual patients.
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Physicians utilise form to order Primary Health Care select forms/materials from vendor.
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Used for the determination of applicant's available monthly income.
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