To facilitate prescribers making reimbursement claims for treatment of Hurler-Scheie and Hurler disease

Form used by IHPs to set up direct bank deposit

Used to determine whether a person who is eligible for homemaking and nurses services is required to pay the fees prescribed for the services.

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.

form used so that new patient to primary health group can join that group due to reasons on form

Form used as part of EDT registration package for IHPs

IHPs apply to submit claim information via EDT

Used by primary care groups who have opted for group enrolment and consent and is only for changing the designated physician of individual patients.

Physicians utilise form to order Primary Health Care select forms/materials from vendor.

Form used to change status of OHIP coverage - i.e., change of address, name, citizenship status, etc. or to cancel OHIP coverage or replacement of lost, stolen and damaged card

Used for the determination of applicant's available monthly income.

Application for Rehabilitation Assessor/Fitter/Dispenser Status

To facilitate prescribers making reimbursement claims for treatment of Niemann Pick Type C (NIPC).

To provide patient advocacy groups with a template for written submissions to the ministry on a drug; the form is to make sure all the appropriate information is provided.

Used to apply for Funding for Pressure Modification Devices

Used by Canadian board -certified orthotists registered with ADP to request funding for custom -made orthoses

Application for Funding Mobility Devices

Used to apply for Funding for Communication Aids

For Specialist physician & ADP registered authorizers to request funding for extraoral (facial) prostheses.

For Specialist physician & ADP registered authorizer to request funding for intraoral (mouth) prostheses.