form to be completed by those eligible for eye exams to be covered under OHIP
Used by clients to request funding assistance for Insulin Pumps and Supplies for Children
The information on this form is used to determine eligibility for grant assistance under the Assistive Devices Program.
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
Form used by IHPs to set up direct bank deposit
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 so that new patient to primary health group can join that group due to reasons on form
Form used as part of EDT registration package for IHPs
IHPs apply to submit claim information via EDT
Used by primary care groups who have opted for group enrolment and consent and is only for changing the designated physician of individual patients.
Physicians utilise form to order Primary Health Care select forms/materials from vendor.
