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004-0430
004-0430e - Declaration of RepresentativeThis form is used by parties appearing before the Fire Safety Commission to identify their legal representative.012-2131
Change of Address NotificationComplete this form to notify the Program Administrator of the Ontario Water Wastewater Operator Certification Program of your change of address.014-3266-54
Application for Reduction of Assessed Co-payment FeesThis form is to be used for a patient who is seeking a reduction to the co-payment or for whom a reduction is sought further to the factors set out in section 10 of Reg. 552 under the Health Insurance Act.014-7521-84
Out of Province Out-patient Servicesform used for out-patient services incurred by visitors from another province014-4721-84
IHP Electronic Data Transfer (EDT) Undertaking and Acknowledgement for Nurse Practitioners (NP)Form used as part of EDT registration package for IHPs014-4342-84
Primary Care-List of Locations Where Group Serv. are Regularly ProvidedForm to show all group locations where physician services provided012-2030
Summary of Planned and Completed Pesticide Aerial ApplicationsA person who operates an airborne machine in performing a land or water extermination is required under regulation to make a summary of applications for each extermination. This is the form to maintain this summary.014-7179-84
Summary of Inpatient Expensesform sent to other provinces for reimbursement of inpatient claims paid (reciprocal)012-2032
Application for a Permit to Use a Pesticide in a Land ExterminationSection 7(1) of the Pesticides Act requires a person to hold a permit issued by the Director for a land extermination unless exempt under regulation. This application form for this purpose.014-4752-84
Undertaking by Interdisciplinary Health Providers (IHP) for Participation in Machine Readable Input (MRI)Form that Interdisciplinary Health Providers will complete and sign agreeing to conform to ministry's technical specifications for claims submission in MRI012-2034
Application for a Permit to Perform a Water ExterminationSection 7(2) of the Pesticides Act requires a person to hold a permit issued by the Director for a water extermination. This application form is for a permit to use a pesticide to control biting flies or aquatic weeds.014-2404-84
Claims Flagged for Manual Reviewform submitted with claims to provide additional information regarding particular claim014-0280-82
Change of InformationForm used to change status of OHIP coverage - i.e., change of address, name, citizenship status, etc. or to cancel OHIP coverage or replacement of lost, stolen and damaged card019-0253
Application for Determination of Surface Rights CompensationIf the owner of surface rights considers that a mining claim holder, of the same land, damaged the owners surface rights and is refusing to compensate the surface rights owner, then that owner can send this form to the Mining and Lands Commissioner.012-1995
Application for Assistant Well Technician Identification Card - Form 8This form is for licensed well contractors and their assistant technicians (not sooner than after four months of employment with the well contractor) interested in applying for or renewing an Assistant Well Technician Identification Card, which expires 36 months following the date of issue. Ontario Regulation 903 prescribes the licensing requirements and outlines the roles and responsibilities for individuals/businesses and activities associated with wells.012-1989
Well Technician Licence Renewal Application - Form 6This form is for Well Technician Licence holders who wish to renew their licence, which expires on March 31 following the year of issue. A Well Technician Licence of the proper prescribed class(es) is required to work at the construction of wells. Ontario Regulation 903 under the Ontario Water Resources Act prescribes the licensing requirements and outlines the roles and responsibilities for individuals/businesses and activities associated with wells.012-4021
Statement of Completion - Environmental Assessment Requirements for Electricity ProjectsProponents of electricity projects must complete the Statement of Completion form once they have satisfied the requirements of the Screening Stage or the Environmental Review Stage of the process, and no requests for the project to be elevated to an individual environmental assessment have been received. The proponent must submit the Statement of Completion to the Ministry of the Environment, upon which the project may proceed subject to any other required approvals.016-2026
File a workplace health and safety complaintComplete and submit this form to file a complaint with the Ministry of Labour, Training and Skills Development's Health and Safety Contact Centre about a workplace health and safety concern.002-02030
Declaration of Representative002-02029
Notice of Withdrawal
