Form that Interdisciplinary Health Providers will complete and sign agreeing to conform to ministry's technical specifications for claims submission in MRI
form used for inpatients to Ontario hospitals who are here visiting from other provinces
form submitted with claims to provide additional information regarding particular claim
form placed on top of bundles of primary care forms, to submit to ministry for processing.
To register ESRD patients for Special Drug Program for provision of Eythropoietins.
form used to provide patient with a comprehensive plan of community-based treatment or care and supervision.
Form completed to request exemption, i.e., no photo to appear on photo health card
To allow patient advocacy groups to register into the database so that they provide written submissions to the ministry on a drug; the form is to make sure all the appropriate information is provided.
The Application Form collects information from applicants regarding their contact information, medical practice and education history.
Used by public health units when conducting cold chain maintenance inspections in premises that store publicly funded vaccines.
Form will be used for NPs to become affiliated with an organization and participate in the NP Service Encounter Tracking and Reporting (SERT) Initiative to receive funding from the MOHLTC
Provider/hospital applies for Interactive Voice Response to verify Health Card numbers via telephone
Physicians complete form to apply for OHIP billing number and/or specialty billing number.
IHPs requesting approval to submit their claims in MRI format
Under Interprovincial agreement, for travel within Canada, patients/physicians submit form to get reimbursed by applicable health plan.
form to be completed by those eligible for eye exams to be covered under OHIP
Eligibility Criteria for Trivalent Inactivated Influenza Vaccine.
