Org Signup

Enter the legal name of your health care organization

Use the search below to find your organization. If they're already a member you can proceed with signing up new users. If no membership agreement is found, you can request OTNhub membership for your organization.

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* Indicates required field

Tell us about your funding model

I am a decision maker or primary contact at a healthcare organization that receives 50% or more of my funding from MOHLTC, LHIN or OHIP on an annual basis.

I am a decision maker or primary contact at a NOT-FOR-PROFIT healthcare organization that receives less than 50% of my funding from MOHLTC, LHIN or OHIP on an annual basis.

I am a decision maker or primary contact at a FOR-PROFIT healthcare organization that receives less than 50% of my funding from MOHLTC, LHIN or OHIP on an annual basis.

Please read and agree to the following statements:

I confirm that I have reviewed and understood the OTN Terms of Service , and I have the authority to bind the organization.

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Primary Contact Information.

I am a primary contact responsible for account management for the organization's telemedicine services, including the approval of any fees associated with the use of OTNhub services when adding new users

Organization Name

Postal Code

Registered Primary Practice Address

Enter registered primary practice address

City

Province

LHIN

OTN is now a part of Ontario Health (OH). OH requests business contact information during the OTNhub sign-up process. OH uses this information to support onboarding, validation and account management. Your business contact information may be provided/published to program delivery partners, other OTNhub member organizations, and OTNhub users to support account management or to respond to virtual care coordination questions.

Legal First Name

Legal Last Name

Middle Initial

Preferred First Name

Preferred Last Name

Job Title

Business Email

Business Phone

Ext

Business Fax

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Apply for additional healthcare professional user accounts

You can provide up to 30 additional users on this application form. Each new user will be required to accept the User Agreements via the OTNhub. Service accounts are associated with individual email accounts. Shared accounts are not permitted under the service agreement.

Ontario Health (OH) requests business contact information during the OTNhub sign-up process. OH uses this information to support onboarding, validation and account management. The business contact information provided may be published on the OTNhub Directory. In certain situations, the contact information may be disclosed to patients who call Ontario Health with non-technical questions about specific virtual care events you coordinate.

New userx

Profession

Nurse Category

Professional Registration Number

Validate

User information is being retrieved

Please wait while we retry retrieving user information...

There seems to be an issue retrieving user information. Please enter user information manually to proceed with the signup.

Legal First Name

Legal Last Name

Middle Initial

Registered with

Registered with Text

Clinical Specialty

Clinical Specialty Text

OHIP Billing Number

Business Email

Business Phone

Ext

Are you applying for additional OTN Services?

Telederm

Emergency Service

What service would you like to get started with?

Do you have a ONE® ID account?

Yes No

Identity Authentication

A representative from Ontario Health will contact you to set up an appointment to complete the identity validation and set up your ONE ID account.

Click here to read more information about ONE ID.

Preferred Appointment Time

Alternative Appointment Time

Delegation Authority

Would the user like to authorize an administrator or nurse to act on to access and use their OTNhub services on their behalf? This person also needs to be registered with a ONE® ID before accessing the user's products and services.

Assign a delegate?

Yes No

Please provide the delegation authority's information:

Same as previous user's delegation authority

Legal First Name

Legal Last Name

Phone

Ext

+ Add an OTNhub user account

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Please review and confirm your information:

Funding Model

Edit Cancel

Funding:

Fees:

Signing Authority

Edit Cancel

Primary Contact

Edit Cancel

User Accounts

By completing this form, you give OTN permission to collect, use and disclose information for the purpose of processing your application and administering the services provided in OTNhub. For questions regarding OTN's privacy practices, please contact privacy@otn.ca.

This form may contain confidential information and its contents should not be distributed, copied or disclosed to any unauthorized persons. If you have accessed a completed form in error, please contact OTN at 1.855.654.0888.

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Organization Signup

Enter the legal name of your health care organization

Tell us about your funding model

Please read and agree to the following statements:

Tell us about your signing authority.

Primary Contact Information.

Apply for additional healthcare professional user accounts

New userx

Please review and confirm your information:

Funding Model

Signing Authority

Primary Contact

User Accounts

Thank you for completing your OTNhub application form.
Applicants will receive an email shortly with next steps.

For applicants with no ONE® ID accounts

For applicants with a ONE® ID account

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Org Signup

Organization Signup

Enter the legal name of your health care organization

Tell us about your funding model

Please read and agree to the following statements:

Tell us about your signing authority.

Primary Contact Information.

Apply for additional healthcare professional user accounts

New userx

Please review and confirm your information:

Funding Model

Signing Authority

Primary Contact

User Accounts

Thank you for completing your OTNhub application form. Applicants will receive an email shortly with next steps.

For applicants with no ONE® ID accounts

For applicants with a ONE® ID account

Recent Comments

Archives

Categories

Meta

Thank you for completing your OTNhub application form.
Applicants will receive an email shortly with next steps.