Bulletin

   
Bulletin Number
        4361
Date
        October 25, 2000
Direct inquiries to

         Ministry of Health
         Processing Office


(address below)
Distribution
       Physicians, Hospitals, Clinics, Laboratories
Subject      Ministry of Community and Social Services (MCSS) Forms
Physicians are reminded that the Ministry of Health and Long-Term Care acts as the payment agent on behalf of MCSS for three uninsured forms listed in Appendix F of the Schedule of Benefits. These include two forms used by the Ontario Disability Support Program (ODSP):

K051 MCSS ODSP Health Status Report Form (HSR) $50.00
K052 MCSS ODSP Activities of Daily Living Form (ADL) $20.00

The third form for the Ontario Works Program formerly titled "OWP Medical Report form" has been revised as follows:

K053 MCSS OW Limitations to Participation Form $15.00

OBSOLETE FORMS

Effective June 1, 1998, MCSS discontinued ‘Form 4’, ‘Form 5’, and the ‘Request for Supplementary Information’ and will no longer accept claims for these obsolete forms. Physicians are reminded to purge these forms from their office supply stock to preclude inadvertent use.

INQUIRIES

Physicians may direct inquiries regarding MCSS forms and their use to the local MCSS office, rather than MOHLTC.

 

Office locations
Barrie
30 Poyntz St.
L4M 3P2
Hamilton
119 King St. W
P.O. Box 2280, Stn. A
L8N 4C8
Kenora
220-808 Robertson St.
P9N 1X9
Kingston
1055 Princess St.
P.O. Box 9000
K7L 5A9
Kitchener
1400 Weber St. E. Unit B2
N2A 3Z8
London
217 York St., 5th FloorP.O. Box 5700
Terminal A
N6A 1B7
Mississauga
201 City Centre Dr.
P.O. Box 7020, Stn. A
L5A 3M1
North Bay
101-447 McKeown St.
P1B 9S9
Oshawa
Exec. Tower,
Oshawa Centre.
419 King St. W.
P.O. Box 635 L1H 8L4
Ottawa
Fuller Building
75 Albert Street
K1P 5Y9
Owen Sound
981 2nd Avenue E.
N4K 2H5
Peterborough
550 Lansdowne St. W.
K9J 8J8
St. Catharines
59 Church St
3rd Floor
L2R 3C3
Sarnia
452 Christina St. N.
N7T 5W4
Sault Ste. Marie
Roberta Bondar Place
70 Foster Dr., Ste. 100
P6A 6V4
Sudbury
199 Larch St.,
Suite 801
P3E 5R1
Thunder Bay
435 James St. S. ,
Suite 113
P7E 6T1
Timmins
38 Pine St. N., Ste. 110
P4N 6K6
Toronto
2195 Yonge St.
P.O Box 1700 Stn. A
M5W 1G9
Windsor
1427 Ouellette Ave.
N8X 1K1
Head Office
P.O. Box 48
Kingston, ON
K7L 5J3