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014-3057-87
Nutrition ProductsUsed for obtaining authorization for nutrition products as an ODB benefit under certai circumstances014-4750-84
Application for IHP GONet Electronic Data Transfer (EDT) ServiceIHPs apply to submit claim information via EDT014-3759-83
Community Treatment Order (CTO) Report Logform used to provide patient with a comprehensive plan of community-based treatment or care and supervision.014-3164-84
Health Card Medical Exemption RequestForm completed to request exemption, i.e., no photo to appear on 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 OHIP014-4297-82
Health Card RenewalForm is generated by client communication system to have people come in to renew photo health card014-7521-84
Out of Province Out-patient Servicesform used for out-patient services incurred by visitors from another province014-7179-84
Summary of Inpatient Expensesform sent to other provinces for reimbursement of inpatient claims paid (reciprocal)012-2032
Application for a Permit to Use a Pesticide in a Land ExterminationSection 7(1) of the Pesticides Act requires a person to hold a permit issued by the Director for a land extermination unless exempt under regulation. This application form for this purpose.014-4815-69
Rate Reduction Application in Long-Term Care - Document List Required for Assessment of Resident EligiblyTo be used by residents of LTC homes who would like to apply for a reduction in the amount of their basic accommodation fees. This document guides applicants in determining which supporting documents will be required as part of their application. This document is to be used by applicants who have a Notice of Assessment.014-1668-69
Application for a Licence to Establish or Maintain and Operate a Nursing HomeApplication for a Licence to Establish or Maintain and Operate a Nursing Home014-4573-84
Primary Health Care Request to Change Designated Physician - Group EnrolmentUsed by primary care groups who have opted for group enrolment and consent and is only for changing the designated physician of individual patients.014-0225-47
Funding Enrollment for E.S.R.D. PatientsTo register ESRD patients for Special Drug Program for provision of Eythropoietins.012-2029
Record of Land and Water Exterminations by an Airborne MachineA person who operates an airborne machine in performing a land or water extermination is required under regulation to make a record of each extermination. This is the form to maintain this record.014-3975-87
Visudyne Therapy Registration/Funding EnrollmentApplication for reimbursement of cost due to use of Visudyne012-2028
Application for a Permit to Perform an Extermination from an Airborne MachineA person who operates an airborne machine in performing a land extermination must hold a permit issued by the Director unless exempt under regulation. This is the application form for this purpose.
