-
014-0918-84
Remittance Advice InquiryForm used by physicians to make inquiries regarding payment details on Remittance Advice014-5056-87
Information Available to Health Care Providers through the Digital Health Drug Repository“The Digital Health Drug Repository (DHDR) Reference Guide may be used by health care providers to understand the inclusions and limitations of the information available through the DHDR.”014-4860-84
Vendor Application for Conformance Testing-Acceptable Use PolicyForm outlines the Conformance Testing-Acceptable Use Policy and is part of agreement between ministry and vendor who must successfully pass the conformance testing.014-4455-64
Universal Influenza Immunization Program Pharmacy FormUniversal Influenza Immunization Program Pharmacy Form for influenza immunization clinics that are eligible for reimbursement through the Universal Influenza Immunization Program.014-4590-64
Response to Adverse Drinking Water Quality Incidents - ResolveThis form is completed by Public Health Boards when MOH site is down.014-4882-83
Oral and Maxillofacial Rehabilitation Program (OMRP) ApplicationForm allows providers to refer patients for assessment for the program and will be used by hospital sites to record patient eligibility.014-4474e-67
Prior Testing Disclosure - Powered Mobility DevicesThis form is used by Manufacturers to report testing of Powered Mobility Devices014-7698-84
Application for OHIP Direct Bank Payment for Health Care Professionalsform used so physicians can have direct deposit of payment of claims014-4589-64
Response to Adverse Drinking Water Quality Incidents - IssueThis form is completed by Public Health Boards when MOH site is down.014-4896-64
Notice of Transfer from a School - Immunization of School Pupils ActNotice of Transfer from a School - Immunization of School Pupils Act014-4575-64
Vaccine Cold Chain Incident Exposure/Wastage ReportUsed by public health units to report vaccine cold chain incidents and wasted or exposed vaccine.014-4311-82
Health Card Re-RegistrationForm is generated by client communication system to have people replace red&white card with photo health card014-5068-39
Health and Well-Being Grant Program Statement of InterestStatement of Interest application form for the Health and Well-Being Grant Program014-3264-54
Hospital Chronic Care Co-payment FormCalculation of Chronic Care Co-Payments for use by hospital staff, patients, and families.
