How to enroll in Visudyne therapy funding — and autofill 014-3975-87 with my-id.ca
Register Visudyne therapy funding without retyping patient and prescriber details
Ophthalmology practices enrolling patients in publicly funded Visudyne photodynamic therapy repeat patient legal name, health number, prescriber registration, and treatment site details on every registration form. 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: Exceptional Access Program — ontario.ca
- Form (Central Forms Repository): Visudyne Therapy Registration/Funding Enrollment — 014-3975-87
What this form is about
Form 014-3975-87 is Visudyne Therapy Registration/Funding Enrollment, used when prescribers register patients for ministry-funded Visudyne (verteporfin) therapy — confirm clinical eligibility and funding rules on ontario.ca.
Before you start: what to gather
- Patient full legal name and Ontario health number.
- Patient address and contact phone.
- Prescriber name and registration number.
- Treatment facility name and address.
Confirm the current process on ontario.ca.
How my-id.ca makes it faster
- Save it once. Store your patient name, health number, and prescriber contact in your my-id.ca profile.
- Keep documents ready. Upload supporting documents to my-id.ca Files so you are not searching at form time.
- 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.
- 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.
Frequently asked questions
- Who completes this form?
- Typically the treating ophthalmologist or clinic staff — confirm on ontario.ca.
- How does my-id.ca help?
- It autofills patient health numbers and prescriber details across specialty drug enrollment forms.
- Is Visudyne covered under Exceptional Access?
- Confirm current funding pathway and clinical criteria on ontario.ca.
Fill it once. Reuse it everywhere.
Save your information in my-id.ca once, then autofill this form and the next one — web forms with the Chrome extension, PDFs right in the app. Your data is stored in Canada and AI runs on my-id.ca's own servers, never sent to third-party AI providers.