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on00328
Review of Emergency Admission to Secure Treatment ProgramThis form is an order completed by the Chair of the Child and Family Services Review Board either releasing the child from the secure treatment program or denying the application.on00159
COVID-19 Vaccine Cold Chain Incident Exposure/Wastage ReportRecord and report COVID-19 cold chain failures by hospitals and long-term care homes to public health units and the ministry.on00028
Form P5Application to the Board to Amend the Conditions of, or Terminate the Appointment of a Representative under Subsection 27(7) or (8) of the Personal Health Information Protection Act.4970-47
Diabetes Education Patient Take Home SummaryThe MedsCheck for Diabetes includes an Annual review that involves using the pharmacist's worksheet and providing the patient with a MedsCheck Personal Medication Record; as well as using a Diabetes Education Checklist and providing the patient with a Diabetes Education Patient Take-Home Summary.014-7026-65
Health Service Organization Information Sheet014-5068-39
Health and Well-Being Grant Program Statement of InterestStatement of Interest application form for the Health and Well-Being Grant Program014-4953-64
Healthy Smiles Ontario - General ApplicationHealthy Smiles Ontario General Application form for the core services stream of the program. This form applies to applicants that have a valid SIN and have filed a statement of income or a tax return with the CRA.014-4941-87
Exceptional Access Program (EAP) Request Fragmin (Dalteparin Sodium) TherapyThe purpose of the e-Form is to assist physicians in the EAP drug request process by integrating all the rules/criteria into an interactive e-Form that will ensure all the necessary information is captured.014-4908-87
Initial Request for Compassionate Review PolicyTo help physicians to submit requests for drug funding for their ODB-eligible patients under the Compassionate Review Policy.014-4815-69
Rate Reduction Application in Long-Term Care - Document List Required for Assessment of Resident EligiblyTo be used by residents of LTC homes who would like to apply for a reduction in the amount of their basic accommodation fees. This document guides applicants in determining which supporting documents will be required as part of their application. This document is to be used by applicants who have a Notice of Assessment.014-4742-84
Application for IHP Group RegistrationForm will be used by IHPs to form a registered group014-4717-87
Submission of Patient EvidenceTo provide patient advocacy groups with a template for written submissions to the ministry on a drug; the form is to make sure all the appropriate information is provided.014-4637-67
Application for Rehabilitation Assessor/Fitter/Dispenser StatusApplication for Rehabilitation Assessor/Fitter/Dispenser Status014-4603-82
Change your home addressChange your address for your driver's licence, vehicle registration, health card and Outdoors Card quickly and easily in one secure, simple transaction. You can choose to notify one or more of three ministries of your address change – Ministry of Transportation, Ministry of Health and Long-Term Care, and Ministry of Natural Resources.