form used, in urgent cases (i.e. patient was in hospital, newborn in NICU) where patient has no family physician so can join primary group.
Hospitals submit form to ministry to obtain Health Number of patient when number is not available
accompanied with form completed by clients to record their wishes for organ/tissue donation
Certificate of Death – Form 1 to be completed by an attending physician or registered nurse in the extended class pursuant to s. 17(2)(a) of Reg. 965 – Hospital Management made under the Public Hospitals Act.
Complete this form if you wish to have the Ministry of Health and Long-Term Care restrict access to your laboratory test information in the Ontario Laboratories Information System (OLIS) after your lab test has been completed.
The 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.
The withdrawal form is to be completed by individuals who have applied and paid to write the Ministry of Health (MOH) Advanced Emergency Medical Care Assistant (AEMCA) exam and now wish to withdraw from the exam.
Form authorizes the ministry to disclose an individual's personal claims history information directly to a third party.
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.
PPLBP forms gather necessary information to help determine the applicant eligibility for the program.
To help physicians to submit requests for drug funding for their ODB-eligible patients under the Compassionate Review Policy.
Receive information required to process Personal Claims History information requests from individuals or individual's substitute decision makers.
Physicians complete form to indicate their preference on how malpractice reimbursement will be sent to them.
The Vendor Registration Application form is an interactive form that will be completed by an Ontario retailer or supplier of home oxygen therapy who is requesting registration with the Assistive Devices Program.
This form is used by manufacturers/distributors of mobility equipment (wheelchairs and wheeled walkers) for the purpose of making application to the Assistive Devices Program requesting approval to list their respective products on the list of approved devices.
