April 2011

As a physician in a Primary Care group you play an integral role in enrolling patients and maintaining your patient roster. The instructions provided in this manual will outline the role that you and your staff have in the process of patient enrolment and the removal of patients from the roster.

This reference manual will assist you with:

• Completing the Patient Enrolment and Consent to Release Personal Health Information forms:
  • #4408-80 See sample Appendix A (Individual Enrolment)
  • #4453-80 See sample Appendix B (Group Enrolment)
• Completing the Request to Change Designated Physician form # 4573-84. See sample Appendix C
• Batching the completed Patient Enrolment and Consent to Release Personal Health Information forms (see Appendix A) for submission to the ministry. This will be referred to as the Enrolment/Consent form(s) in this document
• Following up on rejected Patient Enrolment and Consent to Release Personal Health Information and Primary Care Request to Change Designated Physician forms. See samples Appendices A - C
• Completing Request to Remove Patient form # 3624-84. See sample Appendix E
• Updating your enrolled patients’ addresses (see sample Appendix I) listed as What’s Your Address (Change of Address) form # 1057-82

The Processing Enrolment/Consent Forms Reference Manual For Primary Care Groups is available for download below.

Processing Enrolment/Consent Forms Reference Manual For Primary Care Groups 50 pages | 1 Mb | PDF

Some documents are available in Acrobat PDF format (v 7 minimum). A free copy of the Adobe Acrobat software required to view PDF files is available for downloading. The Adobe website is created by an organization outside of the Ontario government which is solely responsible for the information contained therein.