Authorize health number release without retyping provider and patient details

Health number release forms repeat the patient's name and health number along with the requesting provider's registration 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: Claims submission — Resources for Physicians — ontario.ca
• Form (Central Forms Repository): Health Number Release — 014-1265-84

What this form is about

Form 014-1265-84 is the Health Number Release form used to authorize release of a patient's Ontario health number to an authorized requester.

Before you start: what to gather

• Patient full legal name and health number.
• Requesting provider or organization name and registration details.
• Authorized contact name, address, and phone.
• Purpose of release — confirm on ontario.ca.

Confirm the current process on ontario.ca.

How hivi makes it faster

1. Save it once. Store your patient name and provider contact details 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.