Public Information
Forms
Ontario Drug Benefit Program (ODB)
Forms are listed alphabetically in Portable Document Format (PDF). To view and print the forms, you need to have Adobe Acrobat® Reader installed on your computer. You can download this free software from the Adobe Web site.
Click on the form title to open the form. You can fill-in the form on your screen and print it, or use the disk icon on the Reader toolbar to save a blank copy of the form to your computer. Filled-in forms cannot be saved.
To print, use the printer icon on the Reader toolbar. For form sizes larger than 8.5 x 11 inches, check the Fit to Page box in the print menu window. See the Forms and Applications main menu page for detailed instructions.
| 4551-87 | Application and Consent for the Inherited Metabolic Diseases (ICR) Program | Fill & Print |
| 4423-87 | Notification for Change of Information for Trillium Drug Program | View & Print |
| 4406-87 | Request for an Unlisted Drug Product - ICR | Fill & Print |
| 4252-87 | Request for a Thiazolidinedione for Type 2 Diabetes - EAP | Fill & Print |
| 4247-87 |
”Guide” for the Co-payment Application for Seniors
– Notice to Recipients of Ontario Drug Benefits [PDF] Mail completed Co-payment Applications to the following address for processing : Drug Benefit Programs - MOHLTC Questions regarding the Co-payment Application form/guide should be directed as follows : In Toronto, call 416-503-4586 |
View & Print |
| 3693-87 | Application for Ontario Drug Benefits
Trillium Drug Program Guide (25 pages) | Fill & Print View & Print |
| 3233-87 | Co-payment Application for Seniors | View & Print |
| 3057-87 | Nutrition Products | Paper copy only View & Print |
| 2784-87 | Drug Benefit Claim/Reversal | Fill & Print |
For More Information
Call ServiceOntario, Infoline at 1-866-532-3161
(Toll-free in Ontario only)
TTY 1-800-387-5559. In Toronto, TTY 416-327-4282
Hours of operation : 8:30am - 5:00pm
If you are a member of the media, call Communications and Information Branch at 416-314-6197 or visit our News Room section.
