Forms - Central Forms Repository (CFR)

This form is available on the Ontario Drug Benefit Program Online Applications and Forms website : https://forms.ontariodrugbenefit.ca/. If you are not able to complete the form online, please contact the TDP at 416-642-3038 (Toronto area) or 1-800-575-5386 (outside Toronto) for a paper version of this form.

on00313
Request to End Household Enrolment in the Trillium Drug Program

This form is available on the Ontario Drug Benefit Program Online Applications and Forms website: https://forms.ontariodrugbenefit.ca/. If you are not able to complete the form online, please contact the TDP at 416-642-3038 (Toronto area) or 1-800-575-5386 (outside Toronto) for a paper version of this form.

014-4930-87
Request to Remove a Household Member(s) from the Trillium Drug Program

This form is available on the Ontario Drug Benefit Program Online Applications and Forms website : https://forms.ontariodrugbenefit.ca/. If you are not able to complete the form online, please contact the TDP at 416-642-3038 (Toronto area) or 1-800-575-5386 (outside Toronto) for a paper version of this form.

014-3693-87
Trillium Drug Program Application

The Trillium Drug Program Application is available on the Ontario Drug Benefit Program Online Applications and Forms website: https://forms.ontariodrugbenefit.ca/. If you are not able to complete the form online, please contact the TDP at 416-642-3038 (Toronto area) or 1-800-575-5386 (outside Toronto) for a paper version of this form.

PDF

014-4929-87
Trillium Drug Program Application Signature Request

This form is available on the Ontario Drug Benefit Program Online Applications and Forms website: https://forms.ontariodrugbenefit.ca/. If you are not able to complete the form online, please contact the TDP at 416-642-3038 (Toronto area) or 1-800-575-5386 (outside Toronto) for a paper version of this form.

014-4423-87
Notification for Change of Information for Trillium Drug Program

This form is available on the Ontario Drug Benefit Program Online Applications and Forms website: https://forms.ontariodrugbenefit.ca/. If you are not able to complete the form online, please contact the TDP at 416-642-3038 (Toronto area) or 1-800-575-5386 (outside Toronto) for a paper version of this form.

014-4594-84
Fact Sheet - Gift of Life Consent Form - Organ and Tissue Donor Registration

accompanied with form completed by clients to record their wishes for organ/tissue donation

PDF
HTML

014-1066-41
Form 26 - Notice to the Board of the Need to Schedule a Mandatory Review of the Status of an Informal Patient who is a Child between 12 and 15 Years of Age under Subsection 13(2) of the Act

PDF

014-4777-87
Request for Zavesca® - Niemann Pick Type C (NPC)

To facilitate prescribers making reimbursement claims for treatment of Niemann Pick Type C (NIPC).

339 Forms found for FLR-8A-E

014-2784-87 Drug Benefit Claim Submission Form

014-3780-41 Community Treatment Order (CTO) Information Record

014-1605-41 Form 30 - Notice to Patient under Subsection 38(1) of the Act

014-6429-41 Form 3 - Certificate of Involuntary Admission

014-6428-41 Form 2 - Order for Examination under Section 16

014-3760-41 Form 45 - Community Treatment Order

014-2117-04 Letterhead - Health Professions Regulatory Advisory Council

014-4619-67 Statement of Support for Device Listing - Pressure Modification Devices

014-3056-64 Daily Record of Spa Operation

014-1667-88 Application for Physician Locum Programs

014-4282-64 Prequalification Form for Organizations Requesting Publicly Funded Influenza Vaccine for the 2026/2027 Universal Influenza Immunization Program (UIIP)

014-4931-87 Annual Deductible Re-Assessment Request

on00313 Request to End Household Enrolment in the Trillium Drug Program

014-4930-87 Request to Remove a Household Member(s) from the Trillium Drug Program

014-3693-87 Trillium Drug Program Application

014-4929-87 Trillium Drug Program Application Signature Request

014-4423-87 Notification for Change of Information for Trillium Drug Program

014-4594-84 Fact Sheet - Gift of Life Consent Form - Organ and Tissue Donor Registration

014-1066-41 Form 26 - Notice to the Board of the Need to Schedule a Mandatory Review of the Status of an Informal Patient who is a Child between 12 and 15 Years of Age under Subsection 13(2) of the Act

014-4777-87 Request for Zavesca® - Niemann Pick Type C (NPC)

014-2784-87
Drug Benefit Claim Submission Form

014-3780-41
Community Treatment Order (CTO) Information Record

014-1605-41
Form 30 - Notice to Patient under Subsection 38(1) of the Act

014-6429-41
Form 3 - Certificate of Involuntary Admission

014-6428-41
Form 2 - Order for Examination under Section 16

014-3760-41
Form 45 - Community Treatment Order

014-2117-04
Letterhead - Health Professions Regulatory Advisory Council

014-4619-67
Statement of Support for Device Listing - Pressure Modification Devices

014-3056-64
Daily Record of Spa Operation

014-1667-88
Application for Physician Locum Programs

014-4282-64
Prequalification Form for Organizations Requesting Publicly Funded Influenza Vaccine for the 2026/2027 Universal Influenza Immunization Program (UIIP)

014-4931-87
Annual Deductible Re-Assessment Request

on00313
Request to End Household Enrolment in the Trillium Drug Program

014-4930-87
Request to Remove a Household Member(s) from the Trillium Drug Program

014-3693-87
Trillium Drug Program Application

014-4929-87
Trillium Drug Program Application Signature Request

014-4423-87
Notification for Change of Information for Trillium Drug Program

014-4594-84
Fact Sheet - Gift of Life Consent Form - Organ and Tissue Donor Registration

014-1066-41
Form 26 - Notice to the Board of the Need to Schedule a Mandatory Review of the Status of an Informal Patient who is a Child between 12 and 15 Years of Age under Subsection 13(2) of the Act

014-4777-87
Request for Zavesca® - Niemann Pick Type C (NPC)