Eligibility Criteria for Trivalent Inactivated Influenza Vaccine.

Used by clients/vendors to receive remuneration by direct deposit versus cheque.

Form completed by clients to record their wishes for organ/tissue donation

Form used so patient can submit out of country medical receipts

Form used by physicians to make inquiries regarding payment details on Remittance Advice

Form outlines the Conformance Testing-Acceptable Use Policy and is part of agreement between ministry and vendor who must successfully pass the conformance testing.

form used for out-patient services incurred by visitors from another province

form used so physicians can have direct deposit of payment of claims

form submitted with claims to provide additional information regarding particular claim

form placed on top of bundles of primary care forms, to submit to ministry for processing.

All Long-Term Care Home (LTCH) Inspection reports are posted on the Long-Term Care Homes public website (http://publicreporting.ltchomes.net/en-ca/default.aspx), in English. To request an accessible version or a French version of an Inspection report for a specific LTCH, please complete this form and submit it to the Health Data Branch (HDB), Ministry of Health and Long-Term Care.

Application form completed by rehabilitation professionals applying to Underserviced Area Program for financial incentives, in return for filling full-time vacancies in MOHLTC fully-funded positions in Northern Ontario.

The Vendor Registration Application form is an interactive form that will be completed by an Ontario retailer or supplier of assistive devices who is requesting registration with the Assistive Devices Program.

The Application form collects information from employers to determine their eligibility for funding through the PA Career Start Program.

The form collects contact, recruitment and financial information from applicants who have successfully recruited PA graduates.

The application form is for candidates who have either successfully completed the Paramedic training program provided by an approved College or Training Institution or have been considered equivalent through the MOH Standard Paramedic Equivalency Process and wish to write to write the Ministry of Health (MOH) Advanced Emergency Medical Care Assistant (AEMCA) examination.

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.

PPLBP forms gather necessary information to help determine the applicant eligibility for the program.

The Application Form collects information from applicants regarding their contact information, medical practice and education history.

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.