1,354 Forms found for 013-1857L

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  • 5128
    Ontario Seniors Dental Care Program. Change of Information

    You may use this form if you have applied and are enrolled in the Ontario Seniors Dental Care Program and would like to change the information provided at the time of application. Through this form, you can update applicant information, contact information, marital status and/or spousal information, income declaration, or withdraw consent to disclose personal information and/or personal health information.
  • 045-4805-69
    Application for Reduction in Long-Term Care Home Basic Accommodation - Schedule A: Spouse Dependant

    To be used by residents of LTC homes who would like to apply for a reduction in the amount of their basic accommodation fees. This schedule should be used with one of the four main forms. An applicant should use this schedule if they would like to request a deduction to support an eligible spouse living in the community.
  • 045-4803-69
    Application for Reduction in Long-Term Care Home Basic Accommodation - Resident with a Notice of Assessment and Transitioning to new Government Benefit(s)

    To be used by residents of LTC homes who would like to apply for a reduction in the amount of their basic accommodation fees. This form is to be used by applicants who have a Notice of Assessment from the year when they were 64 years of age.
  • on00605
    Application for Review - Licencing

    Employment Standards Appeal for Licencing
  • on00502
    Laboratory Requisition

    Laboratory Requisition Pursuant to the Mandatory Blood Testing Act, 2006 and O. Reg. 449/07 To support implementation of the Mandatory Blood Testing Act, 2006
  • on00461
    Applicant Report

    Form 2 - Applicant Report - Pursuant to the Mandatory Blood Testing Act, 2006 and O. Reg. 449/07 To support implementation of the Mandatory Blood Testing Act, 2006
  • on00460
    Physician Report

    Form 1 - Physician Report Pursuant to the Mandatory Blood Testing Act, 2006 and O. Reg. 449/07 To support implementation of the Mandatory Blood Testing Act, 2006
  • on00314
    Request for Prior Approval for Full Payment of Insured Out-of-Country (OOC) Health Services

    This form is meant to be submitted by a practicing Ontario physician on behalf of their patients to request consideration of funding for out-of-country health services. Along with the completed application form, submissions must also include relevant medical documentation.
  • on00567
    EV ChargeON Program Guide

    Applicants must meet the Program terms and conditions including the eligibility criteria as set out in this Program Guide. EV ChargeON Program is a competitive, application-based grant program offering up to 50-75% of capital funding through post-construction rebates. Level 2 and Level 3 public Charging Stations are eligible for funding in amounts that are proportional to Charger’s power output. The Program is open to eligible public and private sector applicants.
  • on00520
    Relocation Application (Fixed Site)

    Licensees of Integrated Community Health Services Centres (ICHSCs) must submit an application and obtain written approval from the Director of Integrated Community Health Services Centres prior to a centre’s relocation. For the purposes of this application, a “Fixed Site” centre is a licensed ICHSC where the Limitations and Conditions of the licence specify a single geographic location or address where specified services may be provided.
  • on00565
    Ontario Business Registry Terms and Conditions

    The following are the Terms and Conditions for filing with the Ministry of Public and Business Service Delivery (“Ministry”) under the Business Corporations Act, Business Names Act, Corporations Act, Corporations Information Act, Extra-Provincial Corporations Act, Limited Partnerships Act and Not-for-Profit Corporations Act, 2010.
  • 014-5035-64
    Healthy Smiles Ontario Parent Notification Preventive Services Only Stream (HSO-PSO)

    This form is to be used by Public Health Units after dental screening to notify parents/guardians that their child would benefit from preventive dental services. If the parent/guardian can complete the form and return it to the Public Health Unit if they wish to enroll their child into the Preventive Services Only Stream of Healthy Smiles Ontario.
  • 016-mol-es-002
    Claim Form

    Employment standards are enforced under the Employment Standards Act, 2000 (ESA), which sets out the minimum standards that employers and employees must follow.
  • 014-0406-67
    Authorizer Agreement with the Assistive Devices Program

    The Ministry of Health and Long-Term Care's Assistive Devices Program provides customer centered support and funding to Ontario residents who have long-term physical disabilities to provide access to personalized assistive devices appropriate for the individual's basic needs. To accomplish this goal the ADP must establish relationships with health professionals in order to ensure that ADP clients are assessed for cost-effective devices that best suit their needs.
  • 016-on00139
    Application for Employment Occupational Health and Safety Inspector - Health Care

    Application for Employment to be used in the upcoming Health Care Health & Safety Inspector recruitment for the Ministry of Labour. Applicants will download the form from the Ministry of Labour website and complete the application in order to apply for an Industrial inspector position.
  • 005-0208
    Champion of Diversity Award

    This award recognizes individuals, groups and employers who help promote immigrant success, economic growth, and inclusion in Ontario.
  • 005-0218
    Ontario Medal for Young Volunteers

    This medal program honours outstanding contributions made by exceptional youth volunteers across the province and is the highest honour a young person can achieve for their contributions to the province.
  • 005-0219
    Ontario Medal for Good Citizenship

    This medal program honours individuals for their exceptional long-term efforts and outstanding contributions to the well-being of their communities throughout the province.
  • on00511
    Referral for Tertiary Medical Consultation Service

    The form is used to refer a child/youth to tertiary medical consultation services at CPRI. This is a one-time developmental behavioural consultation with a CPRI paediatrician or a psychiatrist. It can also include diagnostic opinion/interdisciplinary ASD diagnostic assessment. Referrals will only be accepted from a medical specialist (e.g. paediatrician, psychiatrist, neurologist, geneticist). All CPRI recommendations are provided to the referring specialist.
  • 019-0253
    Application for Determination of Surface Rights Compensation

    If 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.