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014-1565-95
Assistive Devices Program Confirmation of Payment InstructionsThe form is an application for direct bank deposit for vendors registered with the Assistive Devices Program.014-4777-87
Request for Zavesca® - Niemann Pick Type C (NPC)To facilitate prescribers making reimbursement claims for treatment of Niemann Pick Type C (NIPC).014-4717-87
Submission of Patient EvidenceTo provide patient advocacy groups with a template for written submissions to the ministry on a drug; the form is to make sure all the appropriate information is provided.014-2860-69
Application for Reimbursement by The ProvinceApplication used by Homemaker and Nurses to request reimbursement from the Province for services provided.014-5053-20
Tobacconist RegistrationFor retailers that primarily sell specialty tobacco products to apply for a tobacconist registration.014-4564-85
Licence Transfer ApplicationTransfer of ownership of Integrated Community Health Services Centre (ICHSC) licence.014-4906-87
Fabry Disease Enzyme Replacement Therapy (Agalsidase) AssessmentApplication form for drug therapy for Fabry disease014-4885-84
Change of Address for Health Care Professionals014-4907-87
Fabry Disease Enzyme Replacement Therapy (Agalsidase) RenewalRenewal form dor drug therapy for Fabry disease014-4954-64
Public Health Unit Requisition for Specimen Shipping SuppliesPublic Health Unit requisition for specimen shipping supplies for rabies testing014-2772-87
Special Authorization (Allergen)Used for obtaining authorization for allergen exact as an ODB benefit014-9998-82
Ontario Health Insurance Plan (OHIP) Document ListThis is accompaniment to Registration for OHIP & Change of Information forms. Lists acceptable ID documents when applying for Ontario health coverage.
