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on00493
Application for Gas Bar Authorization – First Nations On-Reserve Gasoline Retailers OnlyTo be completed by a retailer located on a reserve that wishes to obtain authorization to supply gasoline exempt of tax to First Nation individuals and bands on a reserve for their exclusive use.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.009-0041
Accessibility Innovation Showcase – Volunteer ApplicationApplications for Volunteers to complete for volunteering at the Accessibility Innovation Showcase (September 21, 2017, September 24 - 27, 2017). Deadline to volunteer is August 18, 2017. If you need an alternate format or other accommodation to access this document, please contact Olivia Hall at olivia.hall@ontario.ca or call 437-991-4383.014-4751-84
Interdisciplinary Health Provider (IHP) Nurse Practitioner (NP) Authorization for Participation in the NP Service Encounter Reporting and Tracking (SERT) InitiativeForm will be used for NPs to become affiliated with an organization and participate in the NP Service Encounter Tracking and Reporting (SERT) Initiative to receive funding from the MOHLTC014-2045-67
Release of Information About Previous FundingWritten 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.014-4747-84
Application for IHP Claims Submission and Remittance Advice in Machine Readable Input (MRI)IHPs requesting approval to submit their claims in MRI format0217
June Callwood Outstanding Achievement AwardTo recognize individuals and groups for superlative volunteer contributions to their communities and to the province of Ontario. Up to 20 individuals and/or groups receive this award each year.013-1511
Ontario Manufacturing and Processing Profits Credit Schedule 27This form is to be completed by corporations that are claiming the Ontario manufacturing and processing profits credit and whose active business income is greater than $250,000.014-1057-82
(Change of Address form) What's Your Address?Form used to update/change address information of OHIP cardholders014-4591-87
Request for Elaprase®To facilitate physician's in making an EAP request for funding/reimbursement of Elaprase for Hunter's Syndrome.014-7026-65
Health Service Organization Information Sheet014-3056-64
Daily Record of Spa Operation014-1667-88
Application for Physician Locum Programs014-1470-41
Memorandum of Transfer – NCR Patient014-0265-82
Registration for Ontario Health CoverageForm is used to register new or returning Ontario residents or renew photo Health Card and contains instructions/information.045-2308-69
Profile of Long-Term Care FacilityPart of Nursing Home Inspection Kit5393
Advice to the Director of Posting (Warning) Notice(s)This notice applies to a Drinking Water System only if the system does not use electricity and does not serve any building or other structure that also uses electricity.022-89-1889
Better Jobs Ontario (BJO) Application for Financial AssistanceThis form is completed by individuals applying to the Better Jobs Ontario program.
