Apply for intraoral prosthesis funding without retyping your details

The Assistive Devices Program helps pay for maxillofacial intraoral prostheses — and the application repeats your name, address, health number, plus sections for an authorizer and vendor. This guide is an example of storing them once in hivi.

Official form and source

Start from the official source and always use the current version — form numbers and links can change:

• Service page: Assistive Devices Program — ontario.ca
• Form (Central Forms Repository): Application for Funding Maxillofacial Intraoral Prostheses — 014-4820-67

What this form is about

Form 014-4820-67 is the Application for Funding Maxillofacial Intraoral Prostheses under ADP, with applicant, authorizer, and vendor sections for approved intraoral prosthetic devices.

Before you start: what to gather

• Your name and address.
• Your Ontario health number.
• Clinical assessment from a registered ADP authorizer.
• Vendor device and pricing details for the prosthesis.

Confirm the current process on ontario.ca.

How hivi makes it faster

1. Save it once. Store your name, address, and health number in your hivi profile.
2. Keep documents ready. Upload supporting documents to hivi Files so you are not searching at form time.
3. Autofill the form. Use the hivi Chrome extension on a web form, or fill a PDF from your saved profile inside hivi.
4. Review and submit yourself through the official channel.

Why do it in hivi

Related Ontario forms repeat the same personal details. Captured once in hivi — stored in Canada, with AI on its own servers — every form starts mostly complete.