Primary Health Care

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4832-84 Request for Primary Health Care Enrolment Material Fill & Print
4573-84 Request to Change Designated Physician Form Fill & Print
4431-84 Unattached Patient Declaration Fill & Print
4316-84 Patient Enrolment Batch Header Fill & Print
4324-84 Request for an Interim Assigned Roster Report Fill & Print
4340-84 Time and Location of After Hours Services Fill & Print
4342-84 List of Locations Where Group Services are Regularly Provided Fill & Print
4367-84 Primary Health Care New Patient Declaration 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

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