The Vendor Registration Application form is an interactive form that will be completed by an Ontario retailer or supplier of assistive devices who is requesting registration with the Assistive Devices Program.
form used for inpatients to Ontario hospitals who are here visiting from other provinces
Pharmacists may provide patients with a MedsCheck Patient Take-Home Summary that is intended to further engage patients in identifying ways to build added awareness in their drug therapy and help to identify therapy-related goals.
Using the standardized fax template, pharmacists must share the completed MedsCheck Personal Medication Record with the patient's primary prescriber. A record of the successfully transmitted fax must be kept on file at the pharmacy.
form submitted with claims to provide additional information regarding particular claim
Used by public health units to report vaccine cold chain incidents and wasted or exposed vaccine.
Statement of Interest application form for the Health and Well-Being Grant Program
The Application form collects information from employers to determine their eligibility for funding through the PA Career Start Program.
User Agreement for Pharmacies Requesting Publicly Funded Influenza Vaccine in accordance with the UIIP Prequalification form for health care agencies and workplaces that are required to prequalify in order to receive influenza vaccine.
Prequalification form for health care agencies and workplaces that are required to prequalify in order to receive influenza vaccine.
This form is to be used by fee-for-service dental providers to enroll clients into the Emergency and Essential Services Stream of Healthy Smiles Ontario.
