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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

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Type

Form

Last edited

7/23/2026

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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