How to change a group's designated physician — and autofill 014-4573-84 with my-id.ca

Update designated physician for group enrolment without retyping practice identifiers

Physician groups in patient enrolment models repeat group billing numbers, practice addresses, and outgoing and incoming designated physician details whenever they request a change of designated physician for group enrolment. This guide is an example of storing them once in my-id.ca.

Official form and source

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

• Service page: Resources for physicians — ontario.ca
• Form (Central Forms Repository): Primary Health Care Request to Change Designated Physician - Group Enrolment — 014-4573-84

What this form is about

Form 014-4573-84 is the Primary Health Care Request to Change Designated Physician — Group Enrolment, used when a physician group must update which physician is the designated physician for an enrolment model — confirm rules on ontario.ca.

Before you start: what to gather

• Group practice name and group OHIP billing number.
• Current and new designated physician legal names and billing numbers.
• Practice address and group contact phone or email.
• Effective date for the change — confirm timelines on ontario.ca.

Confirm the current process on ontario.ca.

How my-id.ca makes it faster

1. Save it once. Store your group billing number, physician names, and practice address in your my-id.ca profile.
2. Keep documents ready. Upload supporting documents to my-id.ca Files so you are not searching at form time.
3. Autofill the form. Use the my-id.ca Chrome extension on a web form, or fill a PDF from your saved profile inside my-id.ca.
4. Review and submit yourself through the official channel.

Why do it in my-id.ca

Related Ontario forms repeat the same personal details. Captured once in my-id.ca — stored in Canada, with AI on its own servers — every form starts mostly complete.