27 Forms found for health proxy form

Ministries: Ministry of Labour, Immigration, Training and Skills Development

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  • on00407
    Medical Certificate to Support Entitlement to Family Caregiver Leave, Family Medical Leave, and/or Critical Illness Leave

    This is a form that employees may wish to provide to a qualified health practitioner to fill out, in order to support their eligibility to take one of these leaves.
  • 016-0283
    Consent to Disclose Personal Information Complaints and Work Refusals

    Complaints and Work Refusals Worker consent to authorize the Ministry of Labour and the Workplace Safety and Insurance Board to disclose personal information for the purposes of administering and enforcing the Occupational Health and Safety Act and Section 40 of the Workplace Safety and Insurance Act.
  • 016-0279
    Crane Operator's Medical Certificate

    Amendments to Regulation 854 for Mines and Mining Plants made under the Occupational Health and Safety Act, which came into effect on January 1, 2012, included changes to the medical certificate prescribed under section 195 of the regulation. Under these provisions, operators of cranes are required to undergo a yearly medical examination by a physician. The certificate, which is completed by the physician, provides a convenient way for stakeholders to comply with these requirements. The certificate will take less than five minutes to complete.
  • 016-0275
    Hoist Operator's Medical Certificate

    Amendments to Regulation 854 for Mines and Mining Plants made under the Occupational Health and Safety Act, which came into effect on January 1, 2012, included changes to the medical certificate prescribed under section 238 of the regulation. Under these provisions, operators of mine hoists are required to undergo a yearly medical examination by a physician. The certificate, which is completed by the physician, provides a convenient way for stakeholders to comply with these requirements. The certificate will take less than five minutes to complete.
  • on00905
    Apply for an Extended Temporary Lay-Off

    This application is to request an Extended Temporary Lay-Off under Subsection 66.1(1) of the Employment Standards Act, 2000.
  • 016-1933
    Record Keeping Template

    The Record Keeping Template – This guidance tool is one way that an employer can record the basic occupational health and safety awareness training for their workers and supervisors. This guidance tool is a sample template.
  • 016-1965
    Request for Voluntary Withdrawal of Application or Training Program

    The Request for Voluntary Withdrawal of Application or Training Program form allows Training Provider applicants seeking Chief Prevention Officer (CPO) approval, or currently approved Training Providers to voluntarily withdraw their program(s). By submitting this for the requestor will forfeit their ability to offer the CPO approved health and safety program(s) listed.