Request homemaker or nursing services without retyping client details

Application for Services Form 1 is used to request homemaker or nurse services — and it repeats the applicant's name, address, 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: Home and community care — ontario.ca
• Form (Central Forms Repository): Application for Services Form 1 — 014-2859-69

What this form is about

Form 014-2859-69 (Application for Services Form 1) is used to apply for services of a homemaker or a nurse under Ontario's home and community care programs.

Before you start: what to gather

• Applicant's full legal name and home address.
• Ontario health number if applicable.
• Contact phone and emergency contact.
• Care needs and physician or coordinator referral if required.

Confirm the current process on ontario.ca.

How hivi makes it faster

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