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014-7179-84
Summary of Inpatient Expensesform sent to other provinces for reimbursement of inpatient claims paid (reciprocal)014-3164-84
Health Card Medical Exemption RequestForm completed to request exemption, i.e., no photo to appear on photo health card014-4367-84
Primary Health Care New Patient Declarationform used so that new patient to primary health group can join that group due to reasons on form012-2030
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.014-7026-65
Health Service Organization Information Sheet014-1470-41
Memorandum of Transfer – NCR Patient013-3446
Application for Refund - Summary Loss of Product (PRL)Used by beer vendors in Ontario (e.g., licensed establishments) who paid amounts on account of the beer tax on beer made by Ontario beer manufacturers that was stolen, destroyed (e.g., by fire), or lost (e.g., vehicle accident) prior to the sale of the beer to purchasers. This does not apply to purchases from or through the Liquor Control Board of Ontario.11315e-a
Adoption Information Disclosure, Adopted Person's Guide to Completing and Submitting an Application for Post Adoption Birth InformationTo provide adopted persons with options when submitting a service request to the Office of the Registrar General to complete and submit an application for Post Adoption Birth Information.014-3143-04
New Accused Information Sheet014-4316-84
Patient Enrolment Batch Headerform placed on top of bundles of primary care forms, to submit to ministry for processing.014-4442-97
Return Authorization for Resalable Drugs and Medical SuppliesUse this form if you ordered drugs and/or medical supplies from OGPMSS and wish to return resalable drugs and/or medical supplies to OGPMSS. OGPMSS will only accept returns and provide credit for resalable drugs or supplies that meet the criteria listed on the form. OGPMSS will provide you with a Return Authorization Number within 2 business days upon receipt of a completed form.014-4746-84
Interdisciplinary Health Provider (IHP) Health Number ReleaseForm submitted to ministry to obtain Health Number of patient when not available014-4500-69
Determination of Available Monthly Income Form 4Used for the determination of applicant's available monthly income.008-0102
INFORMATION IN SUPPORT OF WARRANT (TELEWARRANT) under subsections 11(3) AND (5) of the Act (Sex Offender Registry) Form 2This form is to be filled out by police officers seeking to obtain a warrant to arrest a sex offender for the purpose of having him/her comply with the reporting requirements under Christopher's Law. This form is used if they are seeking a warrant via fax – i.e. a telewarrant.