Form used to change status of OHIP coverage - i.e., change of address, name, citizenship status, etc. or to cancel OHIP coverage or replacement of lost, stolen and damaged card
Please be advised, effective July 15, 2024 this form will be removed from the Central Forms Repository. A new, electronic form (on00134) to request consideration of funding for out-of-country health services was implemented April 15, 2024 and is available at:
https://forms.mgcs.gov.on.ca/en/dataset/on00314
Physicians complete form to apply for OHIP billing number and/or specialty billing number.
form used, in urgent cases (i.e. patient was in hospital, newborn in NICU) where patient has no family physician so can join primary group.
Form is generated by client communication system to have people come in to renew photo health card
Form is used to register new or returning Ontario residents or renew photo Health Card and contains instructions/information.
Form used to record hours of physicians in after hours clinics
form sent to other provinces for reimbursement of inpatient claims paid (reciprocal)
Form completed to request exemption, i.e., no photo to appear on photo health card
To 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 from the year when they were 64 years of age.
Under Interprovincial agreement, for travel within Canada, patients/physicians submit form to get reimbursed by applicable health plan.
form used so that new patient to primary health group can join that group due to reasons on form
This form is meant to be submitted by a practicing Ontario physician on behalf of their patients to request consideration of funding for out-of-country health services. Along with the completed application form, submissions must also include relevant medical documentation.
Please be advised, effective July 15, 2024 this form will be removed from the Central Forms Repository. A new, electronic form (on00134) to request consideration of funding for out-of-country health services was implemented April 15, 2024 and is available at:
https://forms.mgcs.gov.on.ca/en/dataset/on00314