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

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.

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.

To facilitate prescribers making reimbursement claims for treatment of Niemann Pick Type C (NIPC).

The MNRF Volunteer Agreement outlines the responsibilities of the volunteer and ministry, and the terms and conditions of the assignment. Agreement must be signed by volunteer and/or parent or guardian (if applicable) and the ministry Supervisor at the start of each volunteer assignment.

Court proceeding and the Information to support a warrant to apprehend and return a child who has been admitted to a secure treatment program.

The MedsCheck for Diabetes includes an Annual review that involves using the pharmacist's worksheet and providing the patient with a MedsCheck Personal Medication Record; as well as using a Diabetes Education Checklist and providing the patient with a Diabetes Education Patient Take-Home Summary.

To help physicians to submit requests for drug funding for their ODB-eligible patients under the Compassionate Review Policy.

You may use this application form to apply for the Ontario Seniors Dental Care Program if you and your spouse (if applicable) have filed your Personal Tax Return(s) with Canada Revenue Agency (CRA) for the most recent tax year and have a valid Social Insurance Number (SIN). If you have a spouse (married or common law partner) who would also like to apply for the Program, they must complete their own application form.

You may use this application form to apply for the Ontario Seniors Dental Care Program if you do not have a valid Social Insurance Number (SIN) and/or if you have not filed your Personal Tax Return(s) with Canada Revenue Agency (CRA) for the most recent tax year. If you have a spouse (married or common law partner) who would also like to apply for the Program, they must complete their own application form.

You may use this form to authorize the program administrator of the Ontario Seniors Dental Care Program to deal with another person (such as your spouse or common-law partner, other family member, friend, or accountant) as your representative for program matters. The same form can be used to cancel a previously-made authorization.

Form 3 - Respondent Report - Pursuant to the Mandatory Blood Testing Act, 2006 and O. Reg. 449/07 To support implementation of the Mandatory Blood Testing Act, 2006

Form 2 - Applicant Report - Pursuant to the Mandatory Blood Testing Act, 2006 and O. Reg. 449/07 To support implementation of the Mandatory Blood Testing Act, 2006

Form 1 - Physician Report Pursuant to the Mandatory Blood Testing Act, 2006 and O. Reg. 449/07 To support implementation of the Mandatory Blood Testing Act, 2006

This form is only to be used by prescribers to request an exemption for Ontario’s Biosimilar Switch Policy for a patient who HAS BEEN USING AN ORIGINATOR BIOLOGIC REIMBURSED THROUGH THE ONTARIO DRUG BENEFIT (ODB) PROGRAM previously authorized through the Exceptional Access Program and is unable to switch from an originator biologic or who is requesting to switch back to the originator following biosimilar switch.

The ICHSC Program must be notified of a change in quality assurance advisor through the submission of the Quality Assurance Advisor form which must be signed by both the centre’s quality assurance advisor and the licensee.

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.