Ontario Drug Benefit (ODB) Program : Application forms
Ready to apply to one of Ontario’s drug programs? You will find many of the forms and guidebooks you need right here. You can open a form, fill it in on your screen and print it, or save a blank copy of the form to your computer.
Don't see a form you need? Talk to your doctor. For some programs, your doctor must complete the form for you..
| TRILLIUM DRUG PROGRAM | |
|---|---|
| 3693-87 | Application for Ontario Drug Benefits Notice to Recipients of Ontario Drug Benefits Mail completed Trillium Drug Program applications to: Questions regarding the Trillium Drug Program application form or guide should be directed to: In Toronto, call 416-642-3038 |
| S46850E-87 | Trillium Drug Program Guide (25 pages) |
| 4423-87 | Notification for Change of Information for Trillium Drug Program |
| SENIORS’ CO-PAYMENT PROGRAM | |
| 3233-87 | Co-payment Application for Seniors Notice to Recipients of Ontario Drug Benefits Mail completed Co-payment applications to: Questions regarding the Co-payment application form or guide should be directed to:: |
| 4247-87 | |
| INHERITED METABOLIC DISEASES PROGRAM | |
| 4551-87 | Application and Consent for the Inherited Metabolic Diseases (IMD) Program |
For More Information
Call ServiceOntario, Infoline at 1-866-532-3161
In Toronto, 416-314-5518
TTY 1-800-387-5559
In Toronto, TTY 416-327-4282
Hours of operation : 8:30am - 5:00pm
