Medical Liability Protection (MLP) Autorisation du - forms ssb gov on 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin with Section 1 – Identification. Fill in your last name, first name, CPSO number, OHIP billing number, and CMPA number clearly.
3. Move to Section 2 – Reimbursement Payment Option. Select either Option A for Advance Reimbursement or Option B for In Year Quarterly Reimbursement by checking the appropriate box.
4. In Section 3 – Declaration, read the terms carefully. Sign and date the form to confirm your understanding and agreement.
5. Ensure all sections are completed fully before submitting the form to the address provided at the top of the document.

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