Claim reimbursement for homemaker or nursing services without retyping your details

Homemakers and nurses who provided eligible services request reimbursement from the province — and the form repeats provider name, business address, and client service details. 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: Home and community care — ontario.ca
• Form (Central Forms Repository): Application for Reimbursement by The Province — 014-2860-69

What this form is about

Form 014-2860-69 is the Application for Reimbursement by The Province, used by homemakers and nurses to request payment for services they provided under Ontario's home and community care framework.

Before you start: what to gather

• Your full legal name or business name and address.
• Client service dates and hours provided.
• Authorization or referral documentation if required.
• Banking or payment instructions if applicable.

Confirm the current process on ontario.ca.

How hivi makes it faster

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