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014-7521-84
Out of Province Out-patient Servicesform used for out-patient services incurred by visitors from another province2182
Request for Notice Under s.7(1) of Local Air Quality Reg for Use of a Specified Dispersion ModelThis form will be used to evaluate requests for the use of a specified dispersion model under s. 7 of Ontario Regulation 419/05: Air Pollution - Local Air Quality (the Regulation) made under the EPA014-4721-84
IHP Electronic Data Transfer (EDT) Undertaking and Acknowledgement for Nurse Practitioners (NP)Form used as part of EDT registration package for IHPs014-4342-84
Primary Care-List of Locations Where Group Serv. are Regularly ProvidedForm to show all group locations where physician services provided013-0940
Ontario Book Publishig Tax Credit (OBPTC) ClaimThis form is to be used when claiming an Ontario book publishing tax credit.012-2030
Summary of Planned and Completed Pesticide Aerial ApplicationsA person who operates an airborne machine in performing a land or water extermination is required under regulation to make a summary of applications for each extermination. This is the form to maintain this summary.017-2100
Places to Grow Implementation Fund ApplicationThe form is for organizations that wish to apply for funding from the Places to Grow Implementation Fund.014-7179-84
Summary of Inpatient Expensesform sent to other provinces for reimbursement of inpatient claims paid (reciprocal)on00326
Emergency Admission to Secure Treatment ProgramThis form is completed by the person in charge of the secure treatment program once the criteria are met for the child's emergency admission to a secure treatment program.017-2031
Application for Matching Education Property Tax AssistanceThis form is to be used by municipalities to apply to the Province of Ontario's Brownfields Financial Tax Incentive Program.012-2032
Application for a Permit to Use a Pesticide in a Land ExterminationSection 7(1) of the Pesticides Act requires a person to hold a permit issued by the Director for a land extermination unless exempt under regulation. This application form for this purpose.014-7698-84
Application for OHIP Direct Bank Payment for Health Care Professionalsform used so physicians can have direct deposit of payment of claims014-4752-84
Undertaking by Interdisciplinary Health Providers (IHP) for Participation in Machine Readable Input (MRI)Form that Interdisciplinary Health Providers will complete and sign agreeing to conform to ministry's technical specifications for claims submission in MRI2947
Canada-Ontario Job Grant (COJG) Employer Registration for ConsortiumThe Employer Registration for Consortium form captures information about the consortium, participating employer, type of business and how many individuals it employs.012-2034
Application for a Permit to Perform a Water ExterminationSection 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 to control biting flies or aquatic weeds.2180
Request Approval Under para 3 s.11(1) LAQR for a Plan for Combined Assessment of Modelled & MeasuredThis form will be used to evaluate requests for approval of a plan for the combined assessment of modelled and monitored results including the use of meterological data for the purpose of refining emissions rates used in the analysis under paragraph 3 of s.11(1) of Ontario Regulation 419/05013-3479
Ontario Retail Sales Tax Purchase Exemption CertificateThis form may be used by people who are qualified to claim an exemption from Retail Sales Tax on contracts of insurance or benefits plans.014-2404-84
Claims Flagged for Manual Reviewform submitted with claims to provide additional information regarding particular claimon00270
Duty Status Graph GridForm 1 is a prescribed graph grid required by Ontario Regulation 555/06: Hours of Service that a driver uses to indicate which duty status they are in at given times throughout the day.014-0280-82
Change of InformationForm used to change status of OHIP coverage - i.e., change of address, name, citizenship status, etc. or to cancel OHIP coverage or replacement of lost, stolen and damaged card