-
014-4858-87
Request for Ilaris® (canakinumab)Application for drug funding014-4901-97
Requisition for NaloxoneRequisition for Naloxone014-4638-67
Authorizer Application - Attachment BAuthorizer Application - Attachment B014-5024-41
Form 4A - Certificate of Continuation014-1782-53
Form 1 - X-ray Equipment Registration014-0403-67
Application for Authorizer StatusApplication for Authorizer Status014-4598-67
PAP Device Evaluation Form014-4258-82
Health Card Renewal - ChildForm is generated by client communication system.045-4767-69-lhin
Application for Determination of Eligibility for Long-Term Care Home Admission (Ontario Health atHome)To be filled out by long-term care (LTC) home applicants as part of the process for determination of eligibility for admission to a LTC home. This completed form is for use by Ontario Health atHome, as the designated placement co-ordinators for long-term care homes, as per the Fixing Long-Term Care Act, 2021, s 47(1).014-4824-67
Application for Funding Visual AidsUsed to apply for Funding for Visual Aids014-3224-67
Application for Funding Hearing DevicesApplication used to determine eligibility for funding by ADP for Hearing Devices.006-fro-014
Third Party Authorization FormThe 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.014-1057-82
(Change of Address form) What's Your Address?Form used to update/change address information of OHIP cardholders
