What the Northern Health Travel Grant specialty provider form asks for — and how to autofill ON00857 with my-id.ca
Certify specialist services for travel grant claims without retyping provider and patient details
Specialist physicians and facilities completing the Northern Health Travel Grant specialty-service provider form repeat patient name, health number, practice address, and billing identifiers on every certification. 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: Northern Health Travel Grant Program — ontario.ca
- Form (Central Forms Repository): Specialty-Service Provider Form for Northern Health Travel Grant — on00857
What this form is about
Form ON00857 is the Specialty-Service Provider Form for the Northern Health Travel Grant, used when a specialist confirms that a Northern Ontario resident travelled for an eligible specialist service — confirm program rules on ontario.ca.
Before you start: what to gather
- Patient full legal name and Ontario health number.
- Specialist name, registration number, and practice address.
- Service date, specialist service provided, and referral details.
- Travel or appointment information linked to the patient's claim — confirm on ontario.ca.
Confirm the current process on ontario.ca.
How my-id.ca makes it faster
- Save it once. Store your patient health number and specialist practice contact details 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?
- The specialist or authorized provider confirming the eligible service — confirm roles on ontario.ca.
- How does my-id.ca help?
- It autofills patient health numbers and specialist practice addresses across northern health travel forms.
- Is this the patient travel grant application?
- No — patients use form 0327-88; ON00857 is the provider certification supporting a claim.
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.