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014-3264-54
Hospital Chronic Care Co-payment FormCalculation of Chronic Care Co-Payments for use by hospital staff, patients, and families.014-2859-69
Application for Services Form 1Application for services of a homemaker or a nurse014-5055-67
Authorizer Registration Change RequestTo maintain registration of health care professionals, termed authorizers, by the Assistive Devices Program4967-47
Pharmacists WorksheetMust be completed for every MedsCheck; pharmacists must have professional notes and/or a worksheet when conducting a MedsCheck.014-4258-82
Health Card Renewal - ChildForm is generated by client communication system.014-3592-41
Residential Home Amendment Form014-06-5040
Long-Term Care Home Inspection Report RequestAll Long-Term Care Home (LTCH) Inspection reports are posted on the Long-Term Care Homes public website (http://publicreporting.ltchomes.net/en-ca/default.aspx), in English. To request an accessible version or a French version of an Inspection report for a specific LTCH, please complete this form and submit it to the Health Data Branch (HDB), Ministry of Health and Long-Term Care.014-4823-67
Application for Funding Pressure Modification DevicesUsed to apply for Funding for Pressure Modification Devices014-4793-67
Application for Funding - Respiratory Equipment & SuppliesUsed to apply for Funding for Respiratory Equipment & Supplies014-3183-67
Application for Funding Limb ProsthesesUsed by Amputee Team, registered with ADP to request funding for conventional upper/lower limb prosthees.014-4519-45
Do Not Resuscitate Confirmation FormUsed by Health Care Facility Staff and Regulated Health Care Providers. Submit completed order request form (available at https://forms.mgcs.gov.on.ca/en/dataset/014-0350-93) to OSSDistribution@ontario.ca.014-0022-84
OHIP Group Registration for Health Care ProfessionalsForm used by physicians to register with group014-4749-84
IHP Electronic Data Transfer (EDT) Undertaking and AcknowledgementForm related to EDT process for IHPs
