Forms
Personal Health Information Office
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.
| 4890-84 | Request for Access to Personal Claims History Information | Fill & Submit |
| 4891-84 | Third Party Request for Personal Claims History Information | Fill & Submit |
Understanding Health Care in Ontario
