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014-4817-69
Long-Term Care Home Support Document List - Submitting NOA that included benefit(s) that a resident is no longer receiving because they have transitioned to new benefit(s)To be used by residents of LTC homes who would like to apply for a reduction in the amount of their basic accommodation fees. This document guides applicants in determining which supporting documents will be required as part of their application. This document is to be used by applicants who have a Notice of Assessment from the year when they were 64 years of age.014-4347-84
Request for Major Eye Examinationform to be completed by those eligible for eye exams to be covered under OHIP014-4478-84
Adjustmentonline form to be available to providers and to Regional Operations staff on a permanent basis on the internet014-2859-69
Application for Services Form 1Application for services of a homemaker or a nurse014-3975-87
Visudyne Therapy Registration/Funding EnrollmentApplication for reimbursement of cost due to use of Visudyne021-0466
Research Standard Questionnaire014-2861-69
Consent to Inspect Assets Form 2Used to determine whether a person who is eligible for homemaking and nurses services is required to pay the fees prescribed for the services.008-0117
Form 11A - Application For Order Of DispositionOntario Society for the Prevention of Cruelty to Animals Act - Application For Order Of Disposition014-4594-84
Fact Sheet - Gift of Life Consent Form - Organ and Tissue Donor Registrationaccompanied with form completed by clients to record their wishes for organ/tissue donation008-0120
Form 14 - General OrderOntario Society for the Prevention of Cruelty to Animals Act - General Order014-3266-54
Application for Reduction of Assessed Co-payment FeesThis form is to be used for a patient who is seeking a reduction to the co-payment or for whom a reduction is sought further to the factors set out in section 10 of Reg. 552 under the Health Insurance Act.014-2860-69
Application for Reimbursement by The ProvinceApplication used by Homemaker and Nurses to request reimbursement from the Province for services provided.008-0116
Form 11 - Report to a Judge or a Justice of the PeaceOntario Society for the Prevention of Cruelty to Animals Act - Report to a Judge or a Justice of the Peace014-7521-84
Out of Province Out-patient Servicesform used for out-patient services incurred by visitors from another province014-4367-84
Primary Health Care New Patient Declarationform used so that new patient to primary health group can join that group due to reasons on form003-nm-005
Nutrient Management Farm Registration FormTo register your Farm Unit under the Nutrient Management Program.014-4721-84
IHP Electronic Data Transfer (EDT) Undertaking and Acknowledgement for Nurse Practitioners (NP)Form used as part of EDT registration package for IHPs