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014-3324e-53
Appointment of Radiation Protection Officer -
014-4508-67
Insulin Pump Product EvaluationUsed to evaluate Insulin pumps4967-47
Pharmacists WorksheetMust be completed for every MedsCheck; pharmacists must have professional notes and/or a worksheet when conducting a MedsCheck.014-4509-67
Application for Equipment Listing Insulin PumpsUse by vendor/manufacturer to apply for equipment listing insulin pumps.014-4853-44
Reinstating Access to Information in the Ontario Laboratories Information System (OLIS)Complete this form if you wish to have the Ministry of Health and Long-Term Care reinstate your laboratory test information in the Ontario Laboratories Information System (OLIS) after your lab test has been completed.014-3057-87
Nutrition ProductsUsed for obtaining authorization for nutrition products as an ODB benefit under certai circumstances014-3056-64
Daily Record of Spa Operation014-1667-88
Application for Physician Locum Programs014-1470-41
Memorandum of Transfer – NCR Patienton00880
Medical Certificate to Support Entitlement to Long-term Illness LeaveThis 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 this leave.4611-45
Paramedic Labour Mobility ApplicationApplication and Verification forms for the Ministry of Health (MOH) Paramedic Labour Mobility Equivalency for Paramedics who hold a valid license or certification in good standing from other Canadian provinces or territories and wish to obtain equivalency in Ontario for their paramedic qualification.014-4471-44
Restricting Access to Patient Records In theOntario Laboratories Information SystemComplete this form if you wish to have the Ministry of Health and Long-Term Care restrict access to your laboratory test information in the Ontario Laboratories Information System (OLIS) after your lab test has been completed.014-4578-64
Laboratory Services Notification (LSN)The Laboratory Services Notification (LSN) form is to be used by small drinking water system owners/operators to notify the local public health unit in writing as to which licensed laboratories will test drinking water samples for their small drinking water systems.014-0000-80
Out of Province Claim for Physician ServicesUnder Interprovincial agreement, for travel within Canada, patients/physicians submit form to get reimbursed by applicable health plan.016-2027
Supporting Ontario's Safe Employers (SOSE) Chief Prevention Officer (CPO) Employer Recognition ApplicationThis is the application form a organization must complete and submit to the Chief Prevention Officer, pursuant the authority under subsection 7.6.2 of the Occupational Health and Safety Act (OHSA), for the purpose of the CPO recognizing organization's Occupational Health and Safety Management System (OHSMS).014-4406-87
Request for an Unlisted Drug Product - Exceptional Access Program (EAP)For faster decisions, prescribers can use the SADIE online portal to submit requests to the Exceptional Access Program (EAP). Sign in through GO Secure (https://www.ebse.health.gov.on.ca) and select SADIE from the services drop-down menu. Visit the SADIE website for more information: http://www.ontario.ca/sadie. Alternatively, this form can be used for submitting requests to the EAP by fax.
