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Form Format
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Adobe PDF   Application for OHIP Billing Number for Health ProfessionalsThe file you are about to download will ONLY work properly if opened with an Adobe Reader 10 or later client. Please do not open this file in a browser.Fill & Print1181.0 kb

Form Classification
Classification / Identification:
 Form Number:014-3384-83Edition date: 2013/11 
 Title:Application for OHIP Billing Number for Health Professionals
 Ministry:Health and Long-Term Care  
 Branch/ABC:Health Service Branch  
 Program:Profiles Analysis Services  
 Purpose of Form:Physicians complete form to apply for OHIP billing number and/or specialty billing number.  

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