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OHIP Fee Consent Form

OHIP covers the basic elements of an eye examination. Little Lake Family Eye Care uses advance diagnostic testing not covered by OHIP to detect and manage eye disease earlier and more precisely, resulting in better health outcomes.

  • OHIP number and Version code (2 letters)
  • MM slash DD slash YYYY

Benefit and Consent Assignment Form

  • MM slash DD slash YYYY
  • MM slash DD slash YYYY