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014-4721-84
IHP Electronic Data Transfer (EDT) Undertaking and Acknowledgement for Nurse Practitioners (NP)Form used as part of EDT registration package for IHPs014-4342-84
Primary Care-List of Locations Where Group Serv. are Regularly ProvidedForm to show all group locations where physician services provided014-4752-84
Undertaking by Interdisciplinary Health Providers (IHP) for Participation in Machine Readable Input (MRI)Form that Interdisciplinary Health Providers will complete and sign agreeing to conform to ministry's technical specifications for claims submission in MRI014-2404-84
Claims Flagged for Manual Reviewform submitted with claims to provide additional information regarding particular claim014-1265-84
Health Number ReleaseHospitals submit form to ministry to obtain Health Number of patient when number is not available019-0253
Application for Determination of Surface Rights CompensationIf the owner of surface rights considers that a mining claim holder, of the same land, damaged the owners surface rights and is refusing to compensate the surface rights owner, then that owner can send this form to the Mining and Lands Commissioner.014-4431-84
Primary Health Care Unattached Patient Declarationform used, in urgent cases (i.e. patient was in hospital, newborn in NICU) where patient has no family physician so can join primary group.014-4442-97
Return Authorization for Resalable Drugs and Medical SuppliesUse this form if you ordered drugs and/or medical supplies from OGPMSS and wish to return resalable drugs and/or medical supplies to OGPMSS. OGPMSS will only accept returns and provide credit for resalable drugs or supplies that meet the criteria listed on the form. OGPMSS will provide you with a Return Authorization Number within 2 business days upon receipt of a completed form.on00580
Statement of Compliance Packaging Materials and Labels Bearing the Meat Inspection LegendApproved meat products packaged and labelled in a provincially licensed meat plant must ensure they are labelled with a meat inspection legend before they are shipped from the facility. The Statement of Compliance Form is completed by new meat plant licence applicants and existing clients to request a Director’s permission to reproduce the meat inspection legend.006-fro-020
REFRAINING ORDERThis form is used when asking the court for a refraining order to prevent the FRO from suspending a driver's licence. If asking for a refraining order, complete the appropriate sections prior to the court date. If you and the FRO lawyer agree on the conditions for the refraining order, complete the form together and provide it to the court clerk for the judge's approval. If you and the FRO lawyer cannot agree, the court will complete the rest of the information, based on what the judge orders.006-fro-019
SUPPORT DEDUCTION ORDERThe 2 forms are used together each time a court makes a support order. When asking the court to make or change a support order, complete the appropriate sections of these forms prior to the court date. The court will complete the rest of the information, based on what the judge orders.012-1866
Application for a Permit to Perform a Water Extermination in Catch Basins for West Nile Virus ControlSection 7(2) of the Pesticides Act requires a person to hold a permit issued by the Director for a water extermination. This application form is for a permit to use a pesticide in catch basin for the control of mosquito larvae that if allowed to mature to adults could be vectors of West Nile Virus.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.006-fro-028
ALTERNATIVE PAYMENT ORDERThe alternative payment order allows a support payor to pay by another method rather than by automatic income deductions under a support deduction order. If you are asking the court to make an alternative payment order, complete the appropriate sections of this form prior to your court date. If you or the support recipient has a lawyer, the lawyer will complete the rest of the form based on what the judge orders. If neither of you has a lawyer, provide the form to the court clerk.on00700
Laboratory Licensing and X-Ray Inspection Services Fees PaymentTo facilitate secure and real-time electronic payments for clinical laboratory licences and x-ray facility application fees using debit and credit cards.014-4751-84
Interdisciplinary Health Provider (IHP) Nurse Practitioner (NP) Authorization for Participation in the NP Service Encounter Reporting and Tracking (SERT) InitiativeForm will be used for NPs to become affiliated with an organization and participate in the NP Service Encounter Tracking and Reporting (SERT) Initiative to receive funding from the MOHLTCon00583
Application for a Non-Shopkeeper- Distributor LicenceYou must hold a non-shopkeeper distributor licence if you meet at least one of the following: • You sell or distribute fluid milk products and do not operate a shop. • You operate a shop and less than 50% by volume of your fluid milk products are sold directly to consumers from your shop. • You are a fluid milk distributor and you don’t buy your milk products from a licensed non-shopkeeper distributor. Licences are issued for a period of up to 3 years and must be renewed before the expiry date stated on the licence.
