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003-0194
Notice of Sitting of Court of RevisionNotice to Property Owner(s) of sitting of court revision.014-3653-41
Dental Claim2179
Notification of Exceedance - Local Air Quality RegulationThis form will be used to collect information relating to measurerd or modelled air-related exceedances as required by s.25(9), s.28(1) and s.30(3) of Ontario Regulation 419/05: Air Pollution - Local Air Quality (the Regulation) made under the EPA014-4897-64
Statement of Conscience or Religious Belief – Immunization of School Pupils ActA parent must complete a Statement of Conscience or Religious Belief and have it witnessed by a commissioner for taking affidavits if they wish to obtain a non-medical exemption for their child from vaccine requirements under the Immunization of School Pupils Act.014-4895-64
Statement of Medical Exemption – Immunization of School Pupils ActA physician or nurse practitioner must complete a Statement of Medical Exemption for children who require a medical exemption from vaccine requirements under the Immunization of School Pupils Act.014-3296-64
Non-Reusable Vaccine (spoiled or expired) Return Record - Toronto ClientsUsed by Toronto clients to return non-reusable vaccines (spoiled or expired) to the Ontario Government Pharmaceutical and Medical Supply Service014-4891-84
Request for Disclosure of Personal Claims History Information to a Third PartyForm authorizes the ministry to disclose an individual's personal claims history information directly to a third party.014-4956-64
Healthy Smiles Ontario – Change of InformationHealthy Smiles Ontario Change of Information form is a paper form submitted by mail as a result of a change during any benefit year. This form is used to add or change information about the applicant, marital status and/or spouse, and children/youth. This form is only required for those who have applied and been enrolled in the core services stream of the program.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.014-4955-64
Healthy Smiles Ontario – Authorizing or Cancelling a RepresentativePaper application required to register via mail. This form is submitted to authorize the MOHLTC (Oshawa) to deal with another person (such as your spouse or common-law partner, other family member, friend, or accountant) as your representative for HSO program matters.026-le238
Image(s), Audio and/or Visual Record(s) Consent, Waiver and Release of LiabilityTo obtain the consent from participants at an OPP event to be recorded in any matter, which could be used for OPP promotional items; users are made aware of this before any recordings are taken007-11333
Statutory Declaration – By Intended ParentsThis Statutory Declaration is to be completed by Intended Parent(s) when certifying a birth using a surrogate.014-4282-64
Prequalification Form for Organizations Requesting Publicly Funded Influenza Vaccine for the 2025/2026 Universal Influenza Immunization Program (UIIP)Prequalification form for health care agencies and workplaces that are required to prequalify in order to receive influenza vaccine.014-5119-84
Consent Authorization Form: Disclosure of Personal Claims History (PCH) Information to Third PartyReceive information required to prove consent provided by individuals or individual's decision makers in order to process Personal Claims History information requests from Third Parties.014-2983-88
Confirmation of Payment Instruction014-3884-41
Review Findings014-3883-41
Program Funding Request014-2002-41
Approval to Purchase Clothing
