Apply for a medical exemption without retyping your identity details

Requests for a medical exemption related to Ontario health card requirements repeat your legal name, date of birth, health number, and contact information. 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: Replace, cancel or change information on your health card — ontario.ca
• Form (Central Forms Repository): Health Card Medical Exemption Request — 014-3164-84

What this form is about

Form 014-3164-84 is the Health Card Medical Exemption Request used when a medical condition affects health card eligibility or renewal requirements.

Before you start: what to gather

• Full legal name, date of birth, and health number.
• Mailing address and contact phone or email.
• Physician or specialist supporting the exemption.
• Medical documentation — confirm on ontario.ca.

Confirm the current process on ontario.ca.

How hivi makes it faster

1. Save it once. Store your name, health number, and address 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.