French - 014-4900-85f - Physician Affiliation...
Dataset description:
The form is used to confirm a physician's qualifications to provide the requested services prior to processing a request to affiliate to a particular ICHSC. The licensee must ensure that...
Source: Physician Affiliation Authorization and Declaration of Professional Standing for ICHSCs
Additional Information
| Last updated | September 25, 2023 |
|---|---|
| Created | December 11, 2021 |
| Format | application/pdf |
| Form Number | https://forms.mgcs.gov.on.ca/dataset/d88192d9-153c-4c4b-b676-530cfd19dbfb/resource/3e7851cc-802e-48fe-bed7-fbc8cc43ebd2/download/4900-85f.pdf |
| Form File Identifier | 014-4900-85f |
| Name | French - 014-4900-85f - Physician Affiliation Authorization and Declaration of Professional Standing for ICHSCs |
| Form File Status | Available |
| Description | |
| Language | French |
| Functionality | Fill, Print, and Save |
| Form File Content Type | Form |
| Remark | |
| Edition Date | 2023-09 |