-
014-4928-87
Updating Private Insurance for Trillium Drug ProgramThis form is available on the Ontario Drug Benefit Program Online Applications and Forms website: https://forms.ontariodrugbenefit.ca/. If you are not able to complete the form online, please contact the TDP at 416-642-3038 (Toronto area) or 1-800-575-5386 (outside Toronto) for a paper version of this form.014-4929-87
Trillium Drug Program Application Signature RequestThis form is available on the Ontario Drug Benefit Program Online Applications and Forms website: https://forms.ontariodrugbenefit.ca/. If you are not able to complete the form online, please contact the TDP at 416-642-3038 (Toronto area) or 1-800-575-5386 (outside Toronto) for a paper version of this form.014-4423-87
Notification for Change of Information for Trillium Drug ProgramThis form is available on the Ontario Drug Benefit Program Online Applications and Forms website: https://forms.ontariodrugbenefit.ca/. If you are not able to complete the form online, please contact the TDP at 416-642-3038 (Toronto area) or 1-800-575-5386 (outside Toronto) for a paper version of this form.014-3889-84
Medical Liability Protection (MLP) Reimbursement Program Authorization/ Direct Deposit RequestPhysicians complete form to indicate their preference on how malpractice reimbursement will be sent to them.016-1966
Claim Form - Protecting Child Performers Act, 2015To enable child performers or their parents or guardians to file a claim under the Protecting Child Performers Act, 2015, which sets out the minimum requirements for employers, child performers and parents or guardians.on00407
Medical Certificate to Support Entitlement to Family Caregiver Leave, Family Medical Leave, and/or Critical Illness LeaveThis is a form that employees may wish to provide to a qualified health practitioner to fill out, in order to support their eligibility to take one of these leaves.016-0279
Crane Operator's Medical CertificateAmendments to Regulation 854 for Mines and Mining Plants made under the Occupational Health and Safety Act, which came into effect on January 1, 2012, included changes to the medical certificate prescribed under section 195 of the regulation. Under these provisions, operators of cranes are required to undergo a yearly medical examination by a physician. The certificate, which is completed by the physician, provides a convenient way for stakeholders to comply with these requirements. The certificate will take less than five minutes to complete.013-1399e
2000 CT23 Short-Form Corporations Tax and Annual Return / Guide # 1401 (2000)Annual corporate tax return and information guide for smaller corporations with permanent establishments in Ontario and meeting specific requirements.013-1399d
2003 CT23 Short-Form Corporations Tax and Annual Return / Guide # 1401C (2003)Annual corporate tax return and information guide for smaller corporations with permanent establishments in Ontario and meeting specific requirements.014-4900-85
Physician Affiliation Authorization and Declaration of Professional Standing for ICHSCsThe form is used to confirm a physician's qualifications to provide the requested services prior to processing a request to affiliate to a particular ICHSC. The licensee must ensure that the physician has been affiliated to the centre before they begin to provide licensed services.on00615
Annual Report of Solution-Mined Salt ProductionThe production of salt by the solution mining method must be reported annually by the operator of a salt solution well.07063
Application for Letters Patent of Amalgamation, Form 11, Corporations ActTo amalgamate two or more active Ontario corporations incorporated under the Corporations Act that have the same or similar objects in order that they may continue as one corporation.014-0951-84
Out-of-Province/Out-of-Country Claim SubmissionForm used so patient can submit out of country medical receipts014-0918-84
Remittance Advice InquiryForm used by physicians to make inquiries regarding payment details on Remittance Advice014-5056-87
Information Available to Health Care Providers through the Digital Health Drug Repository“The Digital Health Drug Repository (DHDR) Reference Guide may be used by health care providers to understand the inclusions and limitations of the information available through the DHDR.”014-4846-87
Request for Aldurazyme®To facilitate prescribers making reimbursement claims for treatment of Hurler-Scheie and Hurler disease023-5080
FMCSA Medical ReportThis form is for drivers that are requesting proof of medical fitness to comply with the Federal Motor Carrier Safety Administration (FMCSA) requirement.014-4573-84
Primary Health Care Request to Change Designated Physician - Group EnrolmentUsed by primary care groups who have opted for group enrolment and consent and is only for changing the designated physician of individual patients.004-0242
Form 3 - Guardianship PlanThis form must be submitted by a person applying to court under the Substitute Decisions Act, 1992 to be appointed guardian of a person who is incapable of personal care.
