Forms
The Ministry of Health is re-instating OHIP coverage for out-of-country emergency hospital, health facility and doctor services retroactive to January 1, 2020 with the same reimbursement rates and the same coverage criteria that existed prior to the cancellation of the Out-of-Country (OOC) Travellers Program.
The program to fund out-of-country dialysis services will continue to be administered by the Ontario Renal Network through their Out-of-Country Hemodialysis Reimbursement Program.
The government strongly recommends that Ontarians travelling outside Canada purchase the appropriate travel health insurance coverage in the event emergency health services are needed and not rely solely on OHIP coverage.
Ontario Health Insurance (OHIP)
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.
If you are mailing your health card forms, see ServiceOntario, Health Card Services for the address of your local OHIP office.
| 4311-82 | Health Card Re-Registration | View & Print |
| 4297-82 | Health Card Renewal | Fill & Print |
| 4258-82 | Health Card Renewal – Child | Fill & Print |
| 1057-82 | (Change of Address Form) What's your address ? | Fill & Print |
| 0280-82 | Change of Information | Paper Copy Only Fill & Print |
| 3750-84 | Organ and Tissue Donor Registration | Paper Copy Only Fill & Print |
| 0951-84 | Out of Province, Out of Country Claim Submission | Fill & Print |
| 0265-82 | Registration for Ontario Health Coverage | Fill & Print |
| 9998E-82 | Ontario Health Coverage Document List | Paper Copy Only |
| 3164-84 | Health Card Medical Exemption Request form | Fill & Print |
Programs and Services
