he purpose of this form is to collect necessary information to obtain authorized consent and assure identity, under the Freedom of Information and Protection of Privacy Act (FIPPA), for application of services delivered by the Ministry of Health on your behalf (or for a “Health Care Group” in which you are a registered member), including:
• Application for an OHIP Billing Number
• Changes to Health Care Group Registration Information
The Early Researcher Award is a discretionary, non-entitlement program that gives funding to new researchers at publicly funded Ontario research institutions to build a research team. Through the completion of this form and supplementary requirements the applicant may be eligible for the review process and award selection. Upon selection, the institution will sign a contract with the Government of Ontario on behalf of the researcher, detailing the terms and conditions for the award.
This application form is for authorized on-reserve tobacco retailers who pay the Ontario Cigar tax when purchasing cigars from their ministry authorized suppliers. Retailers can apply to the ministry for a refund of the cigar tax paid on cigars sold tax-exempt to qualifying First Nation purchasers.
This form is used by surface rights holder(s) to make the withdrawn mining rights available for claim registration.
When the holder of a mining lease, mining licence of occupation or patented mining lands needs other surface rights for the purpose of mining, such as infrastructure buildings or tailings ponds, the client must submit this application form.
Form used as part of EDT registration package for IHPs
Form to show all group locations where physician services provided
Form that Interdisciplinary Health Providers will complete and sign agreeing to conform to ministry's technical specifications for claims submission in MRI
form submitted with claims to provide additional information regarding particular claim
A person who operates an airborne machine in performing a land extermination on Crown Land is required to make a record of each extermination. This is the form to maintain this summary.
Section 7(1) of the Pesticides Act requires a person to hold a permit issued by the Director for a structural extermination unless exempt under regulation. This application form is for a permit to use a fumigant gas or chloropicrin for any fumigation unless exempt under regulation.
Section 7(2) of the Pesticides Act requires a person to hold a permit issued by the Director for a water extermination. This application form is for a permit to use a pesticide in surface water to control of mosquito larvae that if allowed to mature could be vectors of West Nile Virus.
Hospitals submit form to ministry to obtain Health Number of patient when number is not available