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Provider Registration/Change Request FormThis application is to enable currently licensed health care professionals to be able to begin submitting or continue to submit claims to the Ministry of Health (the ministry) for insured services. Options include: • Register for an OHIP Billing Number • Register a Health Care Group • Authorize the ministry to make payments to a health care group on your behalf • Update address, banking, and/or group information • Register for Interactive Voice Response (IVR) • Register for the SAV Portal014-4521-84
Application for Prior Approval for Full Payment of Insured Out-of-Country (OOC) & Out-of-Province (OOP) Laboratory & Genetics TestingThe OOC/OOP PA Program eForm is designed to be completed and submitted electronically for application for prior approval for full payment of insured Out-of-Country (OOC) & Out-of-Province (OOP) laboratory and genetics testing services. English and French versions can be completed online or downloaded and saved for future use.on00646
Ontario Disability Support Program (ODSP) - Mandatory Special Necessities (MSN) Benefit ApplicationApplication may only be completed for recipients of ODSP. The following approved health care professionals licensed to practice in Ontario can complete the application: • Physicians, Nurse Practitioners, Registered Nurses, Occupational Therapists, Physiotherapists, Physician Assistants, and Psychologists* *Psychologists can only complete the Medical Transportation section of the form. The application may only be completed for medical supplies, items, and devices listed in the MSN Schedule of Benefits (https://www.ontario.ca/page/ontario-disability-support-program-health-and-disability-benefits) and items must not be otherwise reimbursed or subject to reimbursement from any other source.on00542
Coroner's Inquest Legal Fee Reimbursement Program and Coroner's Inquest Family Reimbursement Program ApplicationThis application form is for family members (“applicant”) who have been granted standing at a coroner’s inquest where the deceased was a victim of crime or involved in a police-related incident. The applicant or their legal representative can complete this form to apply for reimbursement of eligible legal fees and expenses under either the Coroner’s Inquest Legal Fee Reimbursement Program or the Coroner’s Inquest Family Reimbursement Program. Please consult the Coroner’s Inquest Legal Fee Reimbursement Program/Coroner’s Inquest Family Reimbursement Program Guideline for information on program eligibility criteria, eligible expenses, and the reimbursement process.014-4442-97
Return Authorization for Resalable Drugs and Medical SuppliesUse this form if you ordered drugs and/or medical supplies from OGPMSS and wish to return resalable drugs and/or medical supplies to OGPMSS. OGPMSS will only accept returns and provide credit for resalable drugs or supplies that meet the criteria listed on the form. OGPMSS will provide you with a Return Authorization Number within 2 business days upon receipt of a completed form.on00488
Application for Registration of a Research Facility under s. 4 of the Animals for Research ActA registration is needed if you wish to operate a research, teaching, or testing facility in Ontario. This is required if your premises uses animals in research, teaching or testing and your premises are used for collecting, assembling, or maintaining of animals in connection with a research facility under R.S.O. 1990, c. A.22, s. 4. Please complete this application for registration of a research/teaching/testing facility in full, as per section 4 of the Animals for Research Act. The Director appointed under the Animals for Research Act will approve applications for registrations in accordance with the requirements of the Act. A registration expires on the 31st day of December of the year in which registration is made. Registration must be renewed annually. If an application includes more than one research, teaching or testing facility, details must be provided for each facility in the application, and payment of fees are required.
