Application for Funding Mobility Devices

User Agreement for pharmacies requesting publicly funded vaccine.

The Vendor Registration Application form is an interactive form that will be completed by an Ontario retailer or supplier of assistive devices who is requesting registration with the Assistive Devices Program.

Universal Influenza Immunization Program Reimbursement Form for influenza immunization clinics that are eligible for reimbursement through the Universal Influenza Immunization Program.

Return-of-service agreement between the ministry and the tuition grant recipient

Confirmation that an offer and acceptance of employment has been made for nursing services

Eligibility Criteria for Trivalent Inactivated Influenza Vaccine.

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

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

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

Form created with public health. Eligible uninsured patients diagnosed/treated for TB, physicians submit form to get paid

Form is used to register new or returning Ontario residents or renew photo Health Card and contains instructions/information.

Application form completed by rehabilitation professionals applying to Underserviced Area Program for financial incentives, in return for filling full-time vacancies in MOHLTC fully-funded positions in Northern Ontario.

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.

Form to be completed by providers on behalf of patients seeking prior approval for insured sex-reassignment surgery.

Form used so patient can submit out of country medical receipts

Used by Mental Health Professional to request Rights Advice for both patient and SDM (if indicated). Form completed when Community Treatment Plan (CTP) and Form 49 are issued by physician. Form, CTP and Form 49 faxed to PPAO.

Form used by physicians to make inquiries regarding payment details on Remittance Advice