This form is to be used by Public Health Units after dental screening to notify parents/guardians that their child has an emergency and/or essential dental condition(s). Parents/Guardian will complete the form and return it to the Public Health Unit to let them know that the child has initiated treatment or to attest to financial hardship and enroll into the Emergency and Essential Services Stream of Healthy Smiles Ontario.
The form is used to confirm a physician's qualifications to provide the requested services prior to processing a request to affiliate to a particular ICHSC. The licensee must ensure that the physician has been affiliated to the centre before they begin to provide licensed services.
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 schedule should be used with one of the four main forms. An applicant should use this schedule if their LTC home has notified them that they are eligible for a “Continuation of Previous Dependant Deduction”.
The Small Drinking Water System Identification form is to be used by owners of small drinking water systems to notify in writing the medical officer of health in the health unit where their system is located before supplying drinking water to users of the system following construction or alteration of the small drinking water system or following a shut-down of the system that lasts longer than seven days.
Used by Ministry clients to order forms from OSS Distribution.
form to be completed by those eligible for eye exams to be covered under OHIP
form used so that new patient to primary health group can join that group due to reasons on form
IHPs apply to submit claim information via EDT
Physicians utilise form to order Primary Health Care select forms/materials from vendor.
Used for the determination of applicant's available monthly income.
Claim card used by physicians to receive reimbursement for reciprocal claims
online form to be available to providers and to Regional Operations staff on a permanent basis on the internet
Form used by physicians to register with group
