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Form Format
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Adobe PDF   Application for OHIP Direct Bank Payment for Health Care 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 & Print119.0 kb

Form Classification
Classification / Identification:
 Form Number:014-7698-84Edition date: 2013/11 
 Title:Application for OHIP Direct Bank Payment for Health Care Professionals
 Ministry:Health and Long-Term Care  
 Branch/ABC:Claim Services Branch  
 Program:Claims Services  
 Purpose of Form:form used so physicians can have direct deposit of payment of claims  

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