Get Canada 4347-84e - Ontario 2022-2025

This guide provides step-by-step instructions on how to complete the Canada 4347-84E - Ontario form online. Ensuring accurate and complete information on this document is crucial for accessing major eye examination services.

Follow the steps to fill out the Canada 4347-84E - Ontario form online.

1. Press the ‘Get Form’ button to access the Canada 4347-84E - Ontario form and open it in your chosen editor.
2. Begin by filling out Section 1, Patient Information. Enter the patient's last name, first name, middle name, health number (10 digits), date of birth in the format yyyy/mm/dd, and complete their address, including unit number, street number, city or town, street name, PO Box, province, and postal code. Also, provide their telephone number.
3. Move to Section 2, Patient Medical Information, where you will explain the medical reason that necessitates the patient receiving a major eye exam service annually.
4. In Section 3, provide Physician or Nurse Practitioner Information. Fill in the last name, first name, OHIP billing number, and address of the healthcare provider, including unit number, street number, city or town, street name, PO Box, province, and postal code. Include the provider's telephone number.
5. Sign and date the form in Section 3 to verify the information is true and accurate.
6. Proceed to Section 4, Major Eye Exam Provider Information, and enter the optometrist or physician’s last name and first name.
7. Once all sections are completed, you can save your changes, download, print, or share the completed Canada 4347-84E - Ontario form.

Complete your documents online to access essential eye examination services.