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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 available019-0253
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 IHPs012-2031
Summary of Planned and Completed Pesticide Aerial Applications in Ontario Crown ForestsA 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.014-3653-41
Dental Claim014-4342-84
Primary Care-List of Locations Where Group Serv. are Regularly ProvidedForm to show all group locations where physician services provided007-11314
Adoption Information Disclosure Application to Register or Withdraw a Notice of Contact PreferenceTo allow birth parents and adopted persons submit a service request to the Office of the Registrar General to register or withdraw a Notice of Contact Preference under the Adoption Information Disclosure Act, 2005.on00576
Business Profile – Abattoir and/or Free Standing Meat PlantThe application for a meat plant licence includes the completion of a Business Profile. The Business Profile is to be completed by the licensee and reviewed by OMAFRA. It captures necessary information used to assess the types of regulated activities conducted by the operation and the level of inspection services required at the facility. It also requires updates and resubmission every three years and when any changes occur to any of the contained information.014-4406-87
Request for an Unlisted Drug Product - Exceptional Access Program (EAP)For faster decisions, prescribers can use the SADIE online portal to submit requests to the Exceptional Access Program (EAP). Sign in through GO Secure (https://www.ebse.health.gov.on.ca) and select SADIE from the services drop-down menu. Visit the SADIE website for more information: http://www.ontario.ca/sadie. Alternatively, this form can be used for submitting requests to the EAP by fax.on00583
Application for a Non-Shopkeeper- Distributor LicenceYou must hold a non-shopkeeper distributor licence if you meet at least one of the following: • You sell or distribute fluid milk products and do not operate a shop. • You operate a shop and less than 50% by volume of your fluid milk products are sold directly to consumers from your shop. • You are a fluid milk distributor and you don’t buy your milk products from a licensed non-shopkeeper distributor. Licences are issued for a period of up to 3 years and must be renewed before the expiry date stated on the licence.on00574
Provider Registration/Change Request FormThis application is to enable currently licensed health care professionals to be able to begin submitting or continue to submit claims to the Ministry of Health (the ministry) for insured services. Options include: • Register for an OHIP Billing Number • Register a Health Care Group • Authorize the ministry to make payments to a health care group on your behalf • Update address, banking, and/or group information • Register for Interactive Voice Response (IVR) • Register for the SAV Portal014-4442-97
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.
