Notice of Transfer from a School - Immunization of School Pupils Act

Used by public health units to report vaccine cold chain incidents and wasted or exposed vaccine.

To register ESRD patients for Special Drug Program for provision of Eythropoietins.

Court Proceeding and to apprehend a child who has been admitted to a secure treatment program.

Application for Rehabilitation Assessor/Fitter/Dispenser Status

To facilitate physician's in making an EAP request for funding/reimbursement of Elaprase for Hunter's Syndrome.

To facilitate secure and real-time electronic payments for clinical laboratory licences and x-ray facility application fees using debit and credit cards.

Application used to determine eligibility for funding by ADP for Hearing Devices.

Consent to collect and disclose personal information about the Canadian university, college, and/or facility the applicant has graduated from and the facility they will be completing their return-of-service at.

Used by public health units when conducting cold chain maintenance inspections in premises that store publicly funded vaccines.

The Grow Your Own Nurse Practitioner Initiative Application is the application health care organizations must complete to request participation in the Grow Your Own Nurse Practitioner Initiative.

A parent must complete a Statement of Conscience or Religious Belief and have it witnessed by a commissioner for taking affidavits if they wish to obtain a non-medical exemption for their child from vaccine requirements under the Immunization of School Pupils Act.

A physician or nurse practitioner must complete a Statement of Medical Exemption for children who require a medical exemption from vaccine requirements under the Immunization of School Pupils Act.

Used to apply for financial travel assistance by Northern Ontario residents who must travel long distances to access medical specialist services.

Complete this voluntary aid (Clinician Aid C) if you have been asked by a “Medical Practitioner” or “Nurse Practitioner” to provide a written opinion confirming that the Patient meets the eligibility criteria to receive medical assistance in dying. You should also include the completed aid in the patient's medical records.

The use of this aid is voluntary. It is being provided to assist you in maintaining records for medical assistance in dying. Please use this aid if you are a “Medical Practitioner” or “Nurse Practitioner” and a patient is requesting Advance Consent for MAID Self-Administration.

Receive information required to process Personal Claims History information requests from individuals or individual's substitute decision makers.

Used by Toronto clients to return non-reusable vaccines (spoiled or expired) to the Ontario Government Pharmaceutical and Medical Supply Service

Written consent to release information enables the Assistive Devices Program to provide a history of previously funded equipment/supplies to a client and/or third party as specified.

Provider/hospital applies for Interactive Voice Response to verify Health Card numbers via telephone