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Occupational Therapist Form

Formulaire d'Autorisation de Remboursement et de Réception d'Équipement de la RAMQ

A downloadable Occupational Therapist form for healthcare professionals.
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Specialty

Occupational Therapist

Downloads

0 times

Type

Form

Last edited

2026/07/23

Created by

Heidi Team

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About this form

Optimise assistive device reimbursement documentation with Heidi by automatically completing the Autorisation de remboursement et attestation de prise de possession d’un appareil form for the Régie de l’assurance maladie du Québec (RAMQ). Designed for authorised assistive technology services, this form documents the delivery of mobility equipment and authorises reimbursement under Quebec’s Assistive Devices Program. It captures patient and provider information, device specifications, manufacturer details, serial numbers, associated components and accessories, costs, and the date the equipment was received. The form also records the patient’s acknowledgement of receipt, authorisation for RAMQ reimbursement, and acceptance of responsibilities for the care, return, and appropriate use of the device. Heidi helps clinicians and authorised providers efficiently generate structured documentation that reduces paperwork, supports equipment funding processes, and facilitates timely access to medically necessary mobility equipment.

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How to use this form

1

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Click "Auto-fill Form with Heidi" to open the form in Heidi and complete the fields straight from your note, no copying and pasting.

2

Review and edit

Check the pre-filled details and make any changes before finalising the form.

3

Download or save

Download the completed form or save it directly into your patient records and workflows.

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