Used for obtaining authorization for allergen exact as an ODB benefit

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”.

To be used for all applications for Home Oxygen Therapy funding.

Used to apply for Funding Continuous Glucose Monitors (CGM) Supplies

Used to apply for Funding for Enteral Feeding Pump and Supplies

Application used to determine elegibility for funding by ADP for insulin pumps and supplies

Used by clients to request funding assistance for Insulin Pumps and Supplies for Children

Used by senior clients, 65 years and older, who are on daily insulin injections to apply for funding for syringes.

Application for physicians to apply for HFO Northern and Rural Recruitment & Retention Program

Used by Toronto Clients to order Biological Supplies from Ontario Government Pharmaceutical and Medical Supply Service.

For retailers that primarily sell vapour products to apply for a specialty vape store registration.

Used by clients/vendors to receive remuneration by direct deposit versus cheque.

Used by public health units when conducting cold chain maintenance inspections in premises that store publicly funded vaccines.

To facilitate prescribers making reimbursement claims for treatment of Hurler-Scheie and Hurler disease

For physicians and patients to apply for the Inherited Metabolic Disorders (IMD) Program.

The MedsCheck for Diabetes includes an Annual review that involves using the pharmacist's worksheet and providing the patient with a MedsCheck Personal Medication Record; as well as using a Diabetes Education Checklist and providing the patient with a Diabetes Education Patient Take-Home Summary.

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.

Notice of Transfer from a School - Immunization of School Pupils Act

Used by public health units to report vaccine cold chain incidents and wasted or exposed vaccine.