The Third Party Authorization form authorizes a person other than the payor or recipient to act on the payor's or recipient's behalf. A Family Responsibility Office (FRO) support payor or support recipient may designate this person to request and receive information from the FRO regarding their case.
To facilitate physician's in making an EAP request for funding/reimbursement of Elaprase for Hunter's Syndrome.
Form used to update/change address information of OHIP cardholders
Used for obtaining authorization for nutrition products as an ODB benefit under certai circumstances
Application for reimbursement of cost due to use of Visudyne
Used by clients/vendors to receive remuneration by direct deposit versus cheque.
To facilitate prescribers making reimbursement claims for treatment of Hurler-Scheie and Hurler disease
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 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
