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Application for a Licence to Sell Livestock Medicines under the Animal Health Act, 2009 and (O. Reg. 584/20) (Licences to Sell Livestock Medicines Regulation)A licence is required to sell livestock medicines to owners of livestock or to another person acting on the owner's behalf, for the treatment of the owner's livestock under the Animal Health Act, 2009 and the Licences to Sell Livestock Medicines Regulation.on00581
Voluntary Surrender of a Meat Plant LicenceA licensee of a provincially licensed meat plant may voluntarily surrender their meat plant licence if they no longer conduct regulated activities.on00577
Consent to Revoke a Licence - Issued pursuant to Ontario Regulation 465/19: Fish ProcessingThe licensee of a fish processing operation may consent to the revocation of their licence by a director if the operation no longer conducts regulated activities.014-4816-69
Rate Reduction Application in Long-Term Care - Document List Required for Assessment of Resident without NOATo be used by residents of LTC homes who would like to apply for a reduction in the amount of their basic accommodation fees. This document guides applicants in determining which supporting documents will be required as part of their application. This document is to be used by applicants who do not have a Notice of Assessment.014-3134-84
Application For IVR ParticipationProvider/hospital applies for Interactive Voice Response to verify Health Card numbers via telephone014-4744-84
IHP Application for Direct Bank PaymentForm used by IHPs to set up direct bank deposit014-4316-84
Patient Enrolment Batch Headerform placed on top of bundles of primary care forms, to submit to ministry for processing.014-4746-84
Interdisciplinary Health Provider (IHP) Health Number ReleaseForm submitted to ministry to obtain Health Number of patient when 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 IHPs014-4342-84
Primary Care-List of Locations Where Group Serv. are Regularly ProvidedForm to show all group locations where physician services provided014-4752-84
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 MRI014-2404-84
Claims Flagged for Manual Reviewform submitted with claims to provide additional information regarding particular claim012-2031
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.012-2027
Application for a Permit to Use a Pesticide for Structural Pest ControlSection 7(1) of the Pesticides Act requires a person to hold a permit issued by the Director for a structural extermination unless exempt under regulation. This application form is for a permit to use a fumigant gas or chloropicrin for any fumigation unless exempt under regulation.012-1867
Application for a Permit to Perform a Water Extermination in Surface Water for West Nile Virus ControlSection 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 in surface water to control of mosquito larvae that if allowed to mature could be vectors of West Nile Virus.014-1265-84
Health Number ReleaseHospitals submit form to ministry to obtain Health Number of patient when number is 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.014-4431-84
Primary Health Care Unattached Patient Declarationform used, in urgent cases (i.e. patient was in hospital, newborn in NICU) where patient has no family physician so can join primary group.
