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014-4752-84
Undertaking by Interdisciplinary Health Providers (IHP) for Participation in Machine Readable Input (MRI)Form that Interdisciplinary Health Providers will complete and sign agreeing to conform to ministry's technical specifications for claims submission in MRI014-2404-84
Claims Flagged for Manual Reviewform submitted with claims to provide additional information regarding particular claim014-4316-84
Patient Enrolment Batch Headerform placed on top of bundles of primary care forms, to submit to ministry for processing.on00722
Application to Surrender an Aggregate Licence or Aggregate Permit under the Aggregate Resources ActThe Aggregate Resources Act (ARA) provides for the transfer of a licence or permit. A transferred licence or permit will allow the continued operation of the licensed or permitted site under the same terms, conditions and site plan requirements as the original licence or permit. Any changes or amendments to the site plan or licence/permit conditions are a separate process.012-2146
Freedom of Information Request FormsTo facilitate FOI requests012-2132
Operator-in-Training Certificate and Licence IssuanceComplete this form to request the issuance of drinking water and wastewater operator-in-training (OIT) certificate(s)/licence(s), including water treatment, water distribution/distribution and supply, wastewater treatment and wastewater collection.005-0224
Ontario Medal for Paramedic BraveryRecognizes individual acts of outstanding courage and bravery performed by members of Ontario’s paramedic services. Nominations must be made through the nominee’s paramedic service and endorsed by their Paramedic Chief. Nominations must be submitted by the nominee’s paramedic service.014-2861-69
Consent to Inspect Assets Form 2Used to determine whether a person who is eligible for homemaking and nurses services is required to pay the fees prescribed for the services.014-4746-84
Interdisciplinary Health Provider (IHP) Health Number ReleaseForm submitted to ministry to obtain Health Number of patient when not available012-2142
Change of OwnershipThis form is to be used by the primary or alternate account representative (PAR or AAR) of a participant registered under the Climate Change Mitigation and Low Carbon Economy Act, 2016 to notify the Director of any changes in company or facility ownership pursuant to O. Reg 144/16 The Cap and Trade Program (Cap and Trade Regulation) made under the Climate Change Mitigation and Low Carbon Economy Act, 2016.on00866
Complex Special Needs Service Plan and Budget TemplateComplex Special Needs Service Plan (CSN service plan): is a service plan developed by a CSN placing agency using the recommendations of the CSN Resource Review process. The plan includes a proposed budget and how services funded through the CSN Program will be delivered to support the needs and goals of the child and family.005-0220
Ontario Medal for Police BraveryThis medal recognizes police officers for individual acts of outstanding courage. Nominations must be made through the nominee’s Police Service and endorsed by their Chief of Police or the Commissioner of the Ontario Provincial Police (OPP) for police officers working in the OPP. Nominations must be submitted by the nominee’s Police Service.005-0221
Ontario Medal for Firefighter BraveryThis medal recognizes firefighters for individual acts of outstanding courage. Nominations must be made through the nominee’s Fire Service and endorsed by their Fire Chief. Nominations must be submitted by the nominee’s Fire Service.014-4769-85
Appointment & Acknowledgement of Quality Assurance AdvisorThe ICHSC Program must be notified of a change in quality assurance advisor through the submission of the Quality Assurance Advisor form which must be signed by both the centre’s quality assurance advisor and the licensee.019-0253
Application for Determination of Surface Rights CompensationIf the owner of surface rights considers that a mining claim holder, of the same land, damaged the owners surface rights and is refusing to compensate the surface rights owner, then that owner can send this form to the Mining and Lands Commissioner.014-1265-84
Health Number ReleaseHospitals submit form to ministry to obtain Health Number of patient when number is not available014-4721-84
IHP Electronic Data Transfer (EDT) Undertaking and Acknowledgement for Nurse Practitioners (NP)Form used as part of EDT registration package for IHPs
