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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.014-4723-87
Submission of Patient Evidence Patient Advocacy Groups - Registration FormTo allow patient advocacy groups to register into the database so that they provide written submissions to the ministry on a drug; the form is to make sure all the appropriate information is provided.014-4500-69
Determination of Available Monthly Income Form 4Used for the determination of applicant's available monthly income.006-fro-014
Third Party Authorization FormThe Third Party Authorization form authorizes a person other than the payor or recipient to act on the payor's or recipient's behalf. A Family Responsibility Office (FRO) support payor or support recipient may designate this person to request and receive information from the FRO regarding their case.006-3091
Application to Request Non-Identifying Information Relating to an AdoptionTo allow adopted persons and certain birth family members to request a copy of the adoption file information with information that would reveal the identify of any person other than the requestor removed006-3089
Birth Family Member's Application to Request a Severe Medical SearchTo allow birth family members to request a search for an adopted person, or a member of the adopted person's family, in instances of a severe mental or physical illness004-0009
Request for Review of Children's Aid Society - Child and Family Services Review Board Application - Child and Family Services Act - Section 68To enable a person who has sought or received services from a CAS to make a complaint about certain services to the independent CFSRB.004-0007
Removal of Crown Ward - Child and Family Services Review Board Application - Child and Family Services Act - Section 61To enable a foster parent to request a review of a CAS decision to remove a Crown ward who has lived with the foster parent for at least 2 years.021-0473
Finance Standard Questionnaire021-0472
Governance Standard Questionnaire021-0471
Community Standard Questionnaire021-0467
Exhibit Standard Questionnaire021-0465
Conservation Standard Questionnaire021-0464
Collections Standard Questionnaire014-4717-87
Submission of Patient EvidenceTo provide patient advocacy groups with a template for written submissions to the ministry on a drug; the form is to make sure all the appropriate information is provided.014-4591-87
Request for Elaprase®To facilitate physician's in making an EAP request for funding/reimbursement of Elaprase for Hunter's Syndrome.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.
