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014-4564-85
Licence Transfer ApplicationTransfer of ownership of Integrated Community Health Services Centre (ICHSC) licence.014-2860-69
Application for Reimbursement by The ProvinceApplication used by Homemaker and Nurses to request reimbursement from the Province for services provided.on00383
English - Request for Change in VendorUsed to request a change in vendor for an approved Assistive Devices Program claim014-4519-45
Do Not Resuscitate Confirmation FormUsed by Health Care Facility Staff and Regulated Health Care Providers. Submit completed order request form (available at https://forms.mgcs.gov.on.ca/en/dataset/014-0350-93) to OSSDistribution@ontario.ca.014-4807-69
Application for Reduction in Long-Term Care Home Basic Accommodation - Schedule C: Continuation of Previous Dependant DeductionTo be used by residents of LTC homes who would like to apply for a reduction in the amount of their basic accommodation fees. This schedule should be used with one of the four main forms. An applicant should use this schedule if their LTC home has notified them that they are eligible for a “Continuation of Previous Dependant Deduction”.014-4885-84
Change of Address for Health Care Professionals014-0022-84
OHIP Group Registration for Health Care ProfessionalsForm used by physicians to register with group014-4473e-67
Prior Testing Disclosure - Manual WheelchairThis form is used by Manufacturer's Testing Facilities to report testing of Manual Wheelchairs.014-2772-87
Special Authorization (Allergen)Used for obtaining authorization for allergen exact as an ODB benefit014-4475e-67
Prior Testing Disclosure - Ambulation AidsThis form is used by Manufacturer's Testing Facilities to report testing of Ambulation Aids014-4742-84
Application for IHP Group RegistrationForm will be used by IHPs to form a registered groupon00856
Northern Health Travel Grant Patient Consent for Third-Party Agency RequestThe purpose of this form is for a patient to provide their consent to disclose Personal Health Information to a an NHTG program-approved Third-Party Agency and agree to direct the ministry to pay the entirety of the eligible Northern Health Travel Grant amount to the approved Third-Party Agency listed in the form.
