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on00817
Northern Health Travel Grant Application Online formOnline application form used to apply for financial travel assistance by Northern Ontario residents who must travel long distances to access medical specialist services.014-4344-64
Influenza Vaccine Order Form for the Universal Influenza Immunization ProgramEligibility Criteria for Trivalent Inactivated Influenza Vaccine.014-4846-87
Request for Aldurazyme®To facilitate prescribers making reimbursement claims for treatment of Hurler-Scheie and Hurler disease014-4455-64
Universal Influenza Immunization Program Pharmacy FormUniversal Influenza Immunization Program Pharmacy Form for influenza immunization clinics that are eligible for reimbursement through the Universal Influenza Immunization Program.014-4752-84
Undertaking by Interdisciplinary Health Providers (IHP) for Participation in Machine Readable Input (MRI)Form that Interdisciplinary Health Providers will complete and sign agreeing to conform to ministry's technical specifications for claims submission in MRI014-3264-54
Hospital Chronic Care Co-payment FormCalculation of Chronic Care Co-Payments for use by hospital staff, patients, and families.014-4858-87
Request for Ilaris® (canakinumab)Application for drug funding014-4598-67
PAP Device Evaluation Form014-3523-87
Ontario Drug Programs Enrollment Form014-3884-41
Review Findingson00843
Tuition Support Program for Nurses - Return of Service AgreementReturn-of-service agreement between the ministry and the tuition grant recipienton00841
Tuition Support Program for Nurses - Confirmation of EmploymentConfirmation that an offer and acceptance of employment has been made for nursing services014-4551-87
Application and Consent for the Inherited Metabolic Diseases (IMD) ProgramFor physicians and patients to apply for the Inherited Metabolic Disorders (IMD) Program.014-4791-67
Application for Funding Enteral Feeding Pump and SuppliesUsed to apply for Funding for Enteral Feeding Pump and Supplies014-5109-20
Specialty Vape Store RegistrationFor retailers that primarily sell vapour products to apply for a specialty vape store registration.014-4860-84
Vendor Application for Conformance Testing-Acceptable Use PolicyForm outlines the Conformance Testing-Acceptable Use Policy and is part of agreement between ministry and vendor who must successfully pass the conformance testing.on00315
Consent Form for the Inherited Metabolic Diseases (IMD) ProgramConsent Form for the Inherited Metabolic Diseases (IMD) Program
