-
014-4940-87
Exceptional Access Program (EAP) Request OxyNEO (Oxycodone Hydrochloride Controlled Release) TabletsThe purpose of the e-Form is to assist physicians in the EAP drug request process by integrating all the rules/criteria into an interactive e-Form that will ensure all the necessary information is captured.014-4749-84
IHP Electronic Data Transfer (EDT) Undertaking and AcknowledgementForm related to EDT process for IHPs014-4943-87
Exceptional Access Program (EAP) Request Lovenox (Enoxaparin Sodium) TherapyThe purpose of the e-Form is to assist physicians in the EAP drug request process by integrating all the rules/criteria into an interactive e-Form that will ensure all the necessary information is captured.014-4475e-67
Prior Testing Disclosure - Ambulation AidsThis form is used by Manufacturer's Testing Facilities to report testing of Ambulation Aids014-4942-87
Exceptional Access Program (EAP) Request Innohep (Tinzaparin Sodium) TherapyThe purpose of the e-Form is to assist physicians in the EAP drug request process by integrating all the rules/criteria into an interactive e-Form that will ensure all the necessary information is captured.014-4917-67
Vendor Registration ApplicationThe Vendor Registration Application form is an interactive form that will be completed by an Ontario retailer or supplier of assistive devices who is requesting registration with the Assistive Devices Program.014-4941-87
Exceptional Access Program (EAP) Request Fragmin (Dalteparin Sodium) TherapyThe purpose of the e-Form is to assist physicians in the EAP drug request process by integrating all the rules/criteria into an interactive e-Form that will ensure all the necessary information is captured.014-4918-57
Request for Rights Advice Mental Health InpatientUsed by Mental Health Inpatient Unit staff to request Rights Advice. Form is completed when a physician issues a Mental Health Act form that requires the provision of Rights Advice. Fax form to the PPAO and Rights Adviser will be assigned014-4717-87
Submission of Patient EvidenceTo provide patient advocacy groups with a template for written submissions to the ministry on a drug; the form is to make sure all the appropriate information is provided.014-4442-97
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.012-2063
Municipal Utility Monitoring Program (MUMP) - Lagoons - S1 and S2All owners of “lagoons” should make S1 submissions. A “lagoon” maybe subject to a discharge limit or objective that goes beyond the “conventional” parameters listed on the S1 form. In that case, the information would be entered on the S2 form.004-0420
Summons to a WitnessThis form is used by a party before the Fire Safety Commission to request a summons be issued.004-0424
Summons to a WitnessThis form is used by a party before the Animal Care Review Board to request a summons be issued.004-0423
Application for an Extension of TimeThis form is used by a potential appellant before the Fire Safety Commission to request an extension for filing an appeal outside the statutory period.014-3759-83
Community Treatment Order (CTO) Report Logform used to provide patient with a comprehensive plan of community-based treatment or care and supervision.014-3164-84
Health Card Medical Exemption RequestForm completed to request exemption, i.e., no photo to appear on photo health cardon00503
Application for Renewal of a Licence for the Operation of a Dairy Plant The Milk Act (R.S.O. 1990, c.M12), and Regulations 761Dairy plant licences must be renewed annually. An application for a licence for the operation of a dairy plant must be submitted at least 60 days prior to the expiry date on an existing licence (s. 95( 4), Regulation 761 - Milk and Milk Products under the Milk Act). If you have recently made any of the following changes to your operation, an application for an Amended licence for the operation of a dairy plant must also be submitted: changes to the classes or subclasses of cow's milk processed at the plant; changes to the species of animal ( cow or goat) that produce the milk processed at the plant; or changes to the type of plant operated.004-0428
Adjournment RequestThis form is used by parties appearing before the Animal Care Review Board to request an adjournment of a proceeding.004-0429
Adjournment RequestThis form is used by parties appearing before the Fire Safety Commission to request an adjournment of a proceeding.004-0421
Notice of AppealThis form is used by an appellant to initiate an appeal before the Fire Safety Commission.