The Third Party Authorization form authorizes a person other than the payor or recipient to act on the payor's or recipient's behalf. A Family Responsibility Office (FRO) support payor or support recipient may designate this person to request and receive information from the FRO regarding their case.
Used by clients/vendors to receive remuneration by direct deposit versus cheque.
Application for Rehabilitation Assessor/Fitter/Dispenser Status
To facilitate prescribers making reimbursement claims for treatment of Niemann Pick Type C (NIPC).
To 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.
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.
For faster decisions, prescribers can use the SADIE online portal to submit requests to the Exceptional Access Program (EAP). Sign in through GO Secure (
https://www.ebse.health.gov.on.ca) and select SADIE from the services drop-down menu. Visit the SADIE website for more information:
http://www.ontario.ca/sadie. Alternatively, this form can be used for submitting requests to the EAP by fax.
To facilitate physician's in making an EAP request for funding/reimbursement of Elaprase for Hunter's Syndrome.
Use this form if you ordered drugs and/or medical supplies from OGPMSS and wish to return resalable drugs and/or medical supplies to OGPMSS. OGPMSS will only accept returns and provide credit for resalable drugs or supplies that meet the criteria listed on the form. OGPMSS will provide you with a Return Authorization Number within 2 business days upon receipt of a completed form.
For use by investigating coroners.
For use by investigating coroners.
To be completed by eligible farms under the Nutrient Management Act.
