-
014-2772-87
Special Authorization (Allergen)Used for obtaining authorization for allergen exact as an ODB benefit014-5053-20
Tobacconist RegistrationFor retailers that primarily sell specialty tobacco products to apply for a tobacconist registration.014-4832-84
Primary Health Care Enrolment Material Order FormPhysicians utilise form to order Primary Health Care select forms/materials from vendor.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).014-2860-69
Application for Reimbursement by The ProvinceApplication used by Homemaker and Nurses to request reimbursement from the Province for services provided.014-3715-82
Seasonal Agricultural Workers Registration for Ontario Health CoverageForm used to register specific migrant farm workers for OHIP number014-0265-82
Registration for Ontario Health CoverageForm is used to register new or returning Ontario residents or renew photo Health Card and contains instructions/information.014-4297-82
Health Card RenewalForm is generated by client communication system to have people come in to renew photo health card014-4340-84
Primary Care - Time and Location of After Hours ServicesForm used to record hours of physicians in after hours clinics014-7179-84
Summary of Inpatient Expensesform sent to other provinces for reimbursement of inpatient claims paid (reciprocal)014-3164-84
Health Card Medical Exemption RequestForm completed to request exemption, i.e., no photo to appear on photo health card014-4717-87
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.
