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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 MOHLTC014-3890-22
Clinician Aid B - (Primary) “Medical Practitioner” or “Nurse Practitioner” Medical Assistance in Dying AidThe use of this aid is voluntary. It is being provided to assist you in maintaining records of requests for medical assistance in dying. Please use this aid if you are a “Medical Practitioner” or “Nurse Practitioner” and a patient is requesting medical assistance in dying and it is your intention to provide medical assistance in dying to the patient. You should also include the completed aid in the patient's medical records.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.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.018-fw1023
Application for an Authorization to Conduct Field Trials and TrainingSection 26 of the Fish and Wildlife Conservation Act, 1997 (FWCA) prohibits a person from using a dog to chase live game mammals or game birds during the closed hunting season for the purpose of teaching the dog hunting skills (training) or testing the dog’s hunting skills (field trial) unless the person has the authorization of the Minister. This application can be used to apply for an Authorization to Conduct Field Trials and Training which may be issued to authorize these activities during certain discrete periods of time outside of the hunting season for the game species being chased.on00646
Ontario Disability Support Program (ODSP) - Mandatory Special Necessities (MSN) Benefit ApplicationApplication may only be completed for recipients of ODSP. The following approved health care professionals licensed to practice in Ontario can complete the application: • Physicians, Nurse Practitioners, Registered Nurses, Occupational Therapists, Physiotherapists, Physician Assistants, and Psychologists* *Psychologists can only complete the Medical Transportation section of the form. The application may only be completed for medical supplies, items, and devices listed in the MSN Schedule of Benefits (https://www.ontario.ca/page/ontario-disability-support-program-health-and-disability-benefits) and items must not be otherwise reimbursed or subject to reimbursement from any other source.023-sr-l-105st
Oversize/Overweight Permit Application Single Trip OnlyA single trip permit is issued to facilitate an oversize/overweight move for a one way trip along for a limited time period.on00544
Irrevocable Standby Letter of CreditA letter of credit is a formal written promise made by a financial institution to pay money to a third party. This template is to be used in the context of temporary help agency and recruiter licensing under the Employment Standards Act, 2000.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.014-4747-84
Application for IHP Claims Submission and Remittance Advice in Machine Readable Input (MRI)IHPs requesting approval to submit their claims in MRI format014-4340-84
Primary Care - Time and Location of After Hours ServicesForm used to record hours of physicians in after hours clinics014-7158-84
In-Patient Standard Ward Costsform used for inpatients to Ontario hospitals who are here visiting from other provinces014-4574-64
Vaccine Cold Chain Maintenance Inspection ReportUsed by public health units when conducting cold chain maintenance inspections in premises that store publicly funded vaccines.on00349
Regular Sales Licence Application Livestock Community Sales ActA licence is required to carry out the community sales of consigned livestock in Ontario.014-2045-67
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.014-4347-84
Request for Major Eye Examinationform to be completed by those eligible for eye exams to be covered under OHIP014-4311-82
Health Card Re-RegistrationForm is generated by client communication system to have people replace red&white card with photo health cardon00767
Mandatory Season-End Harvest ReportThis is the Mandatory Season-End Report that is required to be completed by the holder of a Trapping Licence as per the Fish and Wildlife Conservation Act, 1997 and O.Reg. 667/98 (Trapping). Additional instructions can be found on the third page of this form.014-0265-82
Registration for Ontario Health CoverageForm is used to register new or returning Ontario residents or renew photo Health Card and contains instructions/information.
