30 Forms found for 4

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  • 012-1988
    Well Contractor Licence Renewal Application - Form 3

    This form is for Well Contractors Licence holders who wish to renew their licence; which expires on March 31 following the year of issue; and is required by anyone engaging in the business of well construction. Ontario Regulation 903 under the Ontario Water Resources Act prescribes the licensing requirements and outlines the roles and responsibilities for individuals/businesses and activities associated with wells.
  • 014-3134-84
    Application For IVR Participation

    Provider/hospital applies for Interactive Voice Response to verify Health Card numbers via telephone
  • 014-1265-84
    Health Number Release

    Hospitals submit form to ministry to obtain Health Number of patient when number is not available
  • on00785
    Well Evaluation Private Gas Well

    This form is used to collect details about the private well, completed by a Qualified Person. A complete submission includes: - Well Evaluation Form - Well Location Sketch - Ownership documentation - Four photos of the well from N, S, E, W.
  • on00574
    Provider Registration/Change Request Form

    This application is to enable currently licensed health care professionals to be able to begin submitting or continue to submit claims to the Ministry of Health (the ministry) for insured services. Options include: • Register for an OHIP Billing Number • Register a Health Care Group • Authorize the ministry to make payments to a health care group on your behalf • Update address, banking, and/or group information • Register for Interactive Voice Response (IVR) • Register for the SAV Portal
  • 012-1995
    Application for Assistant Well Technician Identification Card - Form 8

    This form is for licensed well contractors and their assistant technicians (not sooner than after four months of employment with the well contractor) interested in applying for or renewing an Assistant Well Technician Identification Card, which expires 36 months following the date of issue. Ontario Regulation 903 prescribes the licensing requirements and outlines the roles and responsibilities for individuals/businesses and activities associated with wells.
  • 012-1989
    Well Technician Licence Renewal Application - Form 6

    This form is for Well Technician Licence holders who wish to renew their licence, which expires on March 31 following the year of issue. A Well Technician Licence of the proper prescribed class(es) is required to work at the construction of wells. Ontario Regulation 903 under the Ontario Water Resources Act prescribes the licensing requirements and outlines the roles and responsibilities for individuals/businesses and activities associated with wells.
  • 012-1987
    Well Contractor Licence Application - Form 1

    This form is for individuals/businesses interested in applying for a new Well Contractor Licence, which is required by anyone engaging in the business of well construction, and expires on March 31 each year following the year of issue. Ontario Regulation 903 under the Ontario Water Resources Act prescribes the licensing requirements and outlines the roles and responsibilities for individuals/businesses and activities associated with wells.
  • 014-4521-84
    Application for Prior Approval for Full Payment of Insured Out-of-Country (OOC) & Out-of-Province (OOP) Laboratory & Genetics Testing

    The OOC/OOP PA Program eForm is designed to be completed and submitted electronically for application for prior approval for full payment of insured Out-of-Country (OOC) & Out-of-Province (OOP) laboratory and genetics testing services. English and French versions can be completed online or downloaded and saved for future use.