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014-4508-67
Insulin Pump Product EvaluationUsed to evaluate Insulin pumps014-3296-64
Non-Reusable Vaccine (spoiled or expired) Return Record - Toronto ClientsUsed by Toronto clients to return non-reusable vaccines (spoiled or expired) to the Ontario Government Pharmaceutical and Medical Supply Service014-2196-67
Application for Funding Mobility DevicesApplication for Funding Mobility Devices014-4940-87
Exceptional Access Program (EAP) Request OxyNEO (Oxycodone Hydrochloride Controlled Release) TabletsThe purpose of the e-Form is to assist physicians in the EAP drug request process by integrating all the rules/criteria into an interactive e-Form that will ensure all the necessary information is captured.014-4943-87
Exceptional Access Program (EAP) Request Lovenox (Enoxaparin Sodium) TherapyThe purpose of the e-Form is to assist physicians in the EAP drug request process by integrating all the rules/criteria into an interactive e-Form that will ensure all the necessary information is captured.014-4473e-67
Prior Testing Disclosure - Manual WheelchairThis form is used by Manufacturer's Testing Facilities to report testing of Manual Wheelchairs.014-4475e-67
Prior Testing Disclosure - Ambulation AidsThis form is used by Manufacturer's Testing Facilities to report testing of Ambulation Aids014-4942-87
Exceptional Access Program (EAP) Request Innohep (Tinzaparin Sodium) TherapyThe purpose of the e-Form is to assist physicians in the EAP drug request process by integrating all the rules/criteria into an interactive e-Form that will ensure all the necessary information is captured.014-2451-67
Application for Funding Home Oxygen TherapyTo be used for all applications for Home Oxygen Therapy funding.014-0265-82
Registration for Ontario Health CoverageForm is used to register new or returning Ontario residents or renew photo Health Card and contains instructions/information.014-5109-20
Specialty Vape Store RegistrationFor retailers that primarily sell vapour products to apply for a specialty vape store registration.on00315
Consent Form for the Inherited Metabolic Diseases (IMD) ProgramConsent Form for the Inherited Metabolic Diseases (IMD) Program014-7179-84
Summary of Inpatient Expensesform sent to other provinces for reimbursement of inpatient claims paid (reciprocal)014-4474e-67
Prior Testing Disclosure - Powered Mobility DevicesThis form is used by Manufacturers to report testing of Powered Mobility Devices
