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014-0280-82
Change of InformationForm 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 card014-4500-69
Determination of Available Monthly Income Form 4Used for the determination of applicant's available monthly income.014-4637-67
Application for Rehabilitation Assessor/Fitter/Dispenser StatusApplication for Rehabilitation Assessor/Fitter/Dispenser Status014-4421-84
Reciprocal ClaimClaim card used by physicians to receive reimbursement for reciprocal claims014-4478-84
Adjustmentonline form to be available to providers and to Regional Operations staff on a permanent basis on the internet014-0265-82
Registration for Ontario Health CoverageForm is used to register new or returning Ontario residents or renew photo Health Card and contains instructions/information.014-4297-82
Health Card RenewalForm is generated by client communication system to have people come in to renew photo health card014-2743-84
Request for Approval of Payment for Proposed Dental Proceduresform completed to obtain approval for dental procedures to be carried out in hospital and covered by OHIP014-7521-84
Out of Province Out-patient Servicesform used for out-patient services incurred by visitors from another province014-1668-69
Application for a Licence to Establish or Maintain and Operate a Nursing HomeApplication for a Licence to Establish or Maintain and Operate a Nursing Home014-4342-84
Primary Care-List of Locations Where Group Serv. are Regularly ProvidedForm to show all group locations where physician services provided014-4746-84
Interdisciplinary Health Provider (IHP) Health Number ReleaseForm submitted to ministry to obtain Health Number of patient when not available014-4340-84
Primary Care - Time and Location of After Hours ServicesForm used to record hours of physicians in after hours clinics
