You may use this application form to apply for the Ontario Seniors Dental Care Program if you do not have a valid Social Insurance Number (SIN) and/or if you have not filed your Personal Tax Return(s) with Canada Revenue Agency (CRA) for the most recent tax year. If you have a spouse (married or common law partner) who would also like to apply for the Program, they must complete their own application form.

Laboratory Requisition Pursuant to the Mandatory Blood Testing Act, 2006 and O. Reg. 449/07 To support implementation of the Mandatory Blood Testing Act, 2006

Form 3 - Respondent Report - Pursuant to the Mandatory Blood Testing Act, 2006 and O. Reg. 449/07 To support implementation of the Mandatory Blood Testing Act, 2006

Form 2 - Applicant Report - Pursuant to the Mandatory Blood Testing Act, 2006 and O. Reg. 449/07 To support implementation of the Mandatory Blood Testing Act, 2006

Form 1 - Physician Report Pursuant to the Mandatory Blood Testing Act, 2006 and O. Reg. 449/07 To support implementation of the Mandatory Blood Testing Act, 2006

This form is to be used by Public Health Units after dental screening to notify parents/guardians that their child would benefit from preventive dental services. If the parent/guardian can complete the form and return it to the Public Health Unit if they wish to enroll their child into the Preventive Services Only Stream of Healthy Smiles Ontario.

The Ministry of Health and Long-Term Care's Assistive Devices Program provides customer centered support and funding to Ontario residents who have long-term physical disabilities to provide access to personalized assistive devices appropriate for the individual's basic needs. To accomplish this goal the ADP must establish relationships with health professionals in order to ensure that ADP clients are assessed for cost-effective devices that best suit their needs.

You may use this form to authorize the program administrator of the Ontario Seniors Dental Care Program to deal with another person (such as your spouse or common-law partner, other family member, friend, or accountant) as your representative for program matters. The same form can be used to cancel a previously-made authorization.

Complete this form if you wish to have the Ministry of Health and Long-Term Care reinstate your laboratory test information in the Ontario Laboratories Information System (OLIS) after your lab test has been completed.

The Ministry of Health and Long-Term Care's Assistive Devices Program provides customer centered support and funding to Ontario residents who have long-term physical disabilities to provide access to personalized assistive devices appropriate for the individual's basic needs. To accomplish this goal the ADP establishes contracts with vendors in order to ensure that ADP funding for clients are in accordance with Program policies.

he purpose of this form is to collect necessary information to obtain authorized consent and assure identity, under the Freedom of Information and Protection of Privacy Act (FIPPA), for application of services delivered by the Ministry of Health on your behalf (or for a “Health Care Group” in which you are a registered member), including: • Application for an OHIP Billing Number • Changes to Health Care Group Registration Information

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.

Application to the Board for a review of a finding of incapacity to manage property under subsection 20.2(1) of the Substitute Decisions Act

The "Low-Volume Claim Submission Claim File Generator" is a tool that allows registered Health Care Professionals/Registered Third-Party Billing Agencies (RTPBAs) to generate a claim file that can be securely submitted to the ministry electronically for the purpose of payment.

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.

The OOC/OOP PA Program eForm is designed to be completed and submitted electronically for application for prior approval for full payment of insured Out-of-Country (OOC) & Out-of-Province (OOP) laboratory and genetics testing services. English and French versions can be completed online or downloaded and saved for future use.

This application is to enable currently licensed health care professionals to be able to begin submitting or continue to submit claims to the Ministry of Health (the ministry) for insured services. Options include: • Register for an OHIP Billing Number • Register a Health Care Group • Authorize the ministry to make payments to a health care group on your behalf • Update address, banking, and/or group information • Register for Interactive Voice Response (IVR) • Register for the SAV Portal