Get Request For Major Eye Exam

Filling out the Request For Major Eye Exam online is a straightforward process that ensures patients receive necessary eye care based on their medical needs. This guide provides step-by-step instructions to help users accurately complete the form with confidence.

Follow the steps to effectively complete the Request For Major Eye Exam.

1. Press the ‘Get Form’ button to access the form and open it in your chosen editor.
2. In Section 1, provide the patient’s information. Fill in their last name, first name, middle name (if applicable), health number, and version code, along with their date of birth, address, city, province, postal code, and telephone number.
3. Move to Section 2 and detail the patient's medical condition. Include specific medical information that justifies the need for a major eye exam every 12 months.
4. In Section 3, input the physician or nurse practitioner's information. This includes their last name, first name, OHIP billing number, address, city, postal code, and contact number.
5. Sign and date the form in the designated area, confirming that all provided information is true and accurate.
6. Finally, in Section 4, enter the major eye exam provider's details such as optometrist or physician’s name and ensure that you understand that this requisition is valid until March 31, five fiscal years after the signature date.
7. Once all sections are completed, save any changes made to the document. You may then download, print, or share the completed form as needed.

Complete your Request For Major Eye Exam online today to ensure timely access to essential eye care.