The use of this aid is voluntary. It is being provided to assist you in maintaining records for medical assistance in dying. Please use this aid if you are a “Medical Practitioner” or “Nurse Practitioner” and a patient is requesting a Waiver of Final Consent. The Waiver of Final Consent is ONLY applicable for individuals whose natural death is reasonably foreseeable (RFND).
This form is only to be used by prescribers to request an exemption for Ontario’s Biosimilar Switch Policy for a patient who HAS BEEN USING AN ORIGINATOR BIOLOGIC REIMBURSED THROUGH THE ONTARIO DRUG BENEFIT (ODB) PROGRAM previously authorized through the Exceptional Access Program and is unable to switch from an originator biologic or who is requesting to switch back to the originator following biosimilar switch.
Used to apply for Funding Continuous Glucose Monitors (CGM) Supplies
Used by clients to request funding assistance for Insulin Pumps and Supplies for Children
Form completed by clients to record their wishes for organ/tissue donation
To facilitate prescribers making reimbursement claims for treatment of Hurler-Scheie and Hurler disease
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 to show all group locations where physician services provided
Application for Rehabilitation Assessor/Fitter/Dispenser Status
Used to apply for Funding for Ocular Prostheses
