340 Forms found for 006-FORM-N-GUIDE

Ministries: Ministry of Health

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  • on00462
    Respondent Report

    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
  • on00502
    Laboratory Requisition

    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
  • on00161
    MOH CYMH Service Description Schedules

    The Service Description Schedule is part of the Transfer Payment Agreement between His Majesty the King in right of Ontario as represented by the Minister of Health (“the Province”) and the Transfer Payment Recipient. The Transfer Payment Recipient will deliver the programs and services in accordance with the requirements as outlined in this Service Description Schedule document in addition to all conditions and requirements within the Transfer Payment Agreement.
  • 014-4297-82
    Health Card Renewal

    Form is generated by client communication system to have people come in to renew photo health card
  • 014-4311-82
    Health Card Re-Registration

    Form is generated by client communication system to have people replace red&white card with photo health card
  • on00461
    Applicant Report

    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
  • on00536
    Low-Volume Claim Submission Claim File Generator

    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.
  • 014-4817-69
    Long-Term Care Home Support Document List - Submitting NOA that included benefit(s) that a resident is no longer receiving because they have transitioned to new benefit(s)

    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 document guides applicants in determining which supporting documents will be required as part of their application. This document is to be used by applicants who have a Notice of Assessment from the year when they were 64 years of age.
  • 014-4956-64
    Healthy Smiles Ontario – Change of Information

    Healthy Smiles Ontario Change of Information form is a paper form submitted by mail as a result of a change during any benefit year. This form is used to add or change information about the applicant, marital status and/or spouse, and children/youth. This form is only required for those who have applied and been enrolled in the core services stream of the program.
  • 014-4953-64
    Healthy Smiles Ontario - General Application

    Healthy Smiles Ontario General Application form for the core services stream of the program. This form applies to applicants that have a valid SIN and have filed a statement of income or a tax return with the CRA.
  • 014-4955-64
    Healthy Smiles Ontario – Authorizing or Cancelling a Representative

    Paper application required to register via mail. This form is submitted to authorize the MOHLTC (Oshawa) to deal with another person (such as your spouse or common-law partner, other family member, friend, or accountant) as your representative for HSO program matters.
  • 014-4874-77
    Pregnancy and Parental Leave Benefits Program (for Physicians)

    PPLBP forms gather necessary information to help determine the applicant eligibility for the program.
  • on00347
    Request for Disclosure of Personal Claims History (PCH) Information to a Third Party (for High-Volume Submitters)

    The eForm is currently unavailable at this time. We would like to have the option to re-activate the eForm at a later date.
  • 014-4818-69
    Long-Term Care Home Support Document List - Resident Receiving ODSP

    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 document guides applicants in determining which supporting documents will be required as part of their application. This document is to be used by applicants who are receiving benefits from the Ontario Disability Support Program.
  • 014-2045-67
    Release of Information About Previous Funding

    Written consent to release information enables the Assistive Devices Program to provide a history of previously funded equipment/supplies to a client and/or third party as specified.
  • 014-5126-20
    Ontario Seniors Dental Care Program Application Through Guarantor

    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.
  • 014-5035-64
    Healthy Smiles Ontario Parent Notification Preventive Services Only Stream (HSO-PSO)

    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.
  • on00521
    Exceptional Access Program (EAP) – Biosimilar Exemption Request

    This form is only to be used by prescribers to request an exemption for Ontario’s Biosimilar Switch Policy for a patient who HAS BEEN USING AN ORIGINATOR BIOLOGIC REIMBURSED THROUGH THE ONTARIO DRUG BENEFIT (ODB) PROGRAM previously authorized through the Exceptional Access Program and is unable to switch from an originator biologic or who is requesting to switch back to the originator following biosimilar switch.
  • 014-4442-97
    Return Authorization for Resalable Drugs and Medical Supplies

    Use this form if you ordered drugs and/or medical supplies from OGPMSS and wish to return resalable drugs and/or medical supplies to OGPMSS. OGPMSS will only accept returns and provide credit for resalable drugs or supplies that meet the criteria listed on the form. OGPMSS will provide you with a Return Authorization Number within 2 business days upon receipt of a completed form.
  • 014-4521-84
    Application for Prior Approval for Full Payment of Insured Out-of-Country (OOC) & Out-of-Province (OOP) Laboratory & Genetics Testing

    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.