Complete your Northern Health Travel Grant patient consent form, fast

When a third-party agency helps you access the Northern Health Travel Grant, you may need to sign a patient consent form authorizing them to act on your behalf. This guide is an example of storing your personal details in hivi so the patient section fills quickly.

Official form and source

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

• Service page: Northern Health Travel Grant — ontario.ca
• Form (Central Forms Repository): Northern Health Travel Grant Patient Consent for Third-Party Agency Request — on00856

What this form is about

This consent form authorizes a specific agency — such as a band office, Indigenous health organization, or community support service — to request Northern Health Travel Grant information or assistance on your behalf. It does not replace the grant application itself.

Before you start: what to gather

• Your full legal name and Ontario health number.
• Your current address and contact details.
• The name and details of the agency you are authorizing.

How hivi makes it faster

1. Store your personal details once. Add your name, address, and health number to hivi — the same details used on the grant application forms.
2. Autofill the patient section. Use the hivi Chrome extension on a web form, or fill a PDF from your saved profile inside hivi.
3. Fill in the agency details specific to this authorization.
4. Sign and provide the completed consent to the authorized agency.

Why do it in hivi

Northern Ontario residents often deal with multiple health travel grant forms — the application, the online version, and now this consent form. Stored once in hivi — in Canada, with self-hosted AI — your personal details section is always ready.