-
014-4372-64
Universal Influenza Immunization Program Reimbursement FormUniversal Influenza Immunization Program Reimbursement Form for influenza immunization clinics that are eligible for reimbursement through the Universal Influenza Immunization Program.014-4455-64
Universal Influenza Immunization Program Pharmacy FormUniversal Influenza Immunization Program Pharmacy Form for influenza immunization clinics that are eligible for reimbursement through the Universal Influenza Immunization Program.0215
Volunteer Service AwardsTo recognize youth and adult volunteers for continuous years of commitment and dedicated service to an organization.014-4721-84
IHP Electronic Data Transfer (EDT) Undertaking and Acknowledgement for Nurse Practitioners (NP)Form used as part of EDT registration package for IHPs003-0166
Affidavit of Clerk – Form 5Form that officially confirms the passing of the by-law by a municipality for borrowing money for the construction of drainage works.2953
Canada-Ontario Job Grant (COJG) Training AgreementFor use by Canada-Ontario Job Grant (COJG) Service Providers when entering into training agreements with approved Employers006-3183
Vision Care Benefit (Exceptional Circumstances)The form is for requests for medically necessary items that are not in the Ministry of Community and Social Services (MCSS) Vision Care Fee Schedule. Requests may be made where exceptional medical circumstances exist. Service providers must obtain pre-authorization from MCSS before providing Exceptional Circumstances services to clients.017-2100
Places to Grow Implementation Fund ApplicationThe form is for organizations that wish to apply for funding from the Places to Grow Implementation Fund.014-4340-84
Primary Care - Time and Location of After Hours ServicesForm used to record hours of physicians in after hours clinics