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014-4573-84
Primary Health Care Request to Change Designated Physician - Group EnrolmentUsed by primary care groups who have opted for group enrolment and consent and is only for changing the designated physician of individual patients.014-4752-84
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 MRI014-7158-84
In-Patient Standard Ward Costsform used for inpatients to Ontario hospitals who are here visiting from other provinces014-2404-84
Claims Flagged for Manual Reviewform submitted with claims to provide additional information regarding particular claim014-4316-84
Patient Enrolment Batch Headerform placed on top of bundles of primary care forms, to submit to ministry for processing.014-4815-69
Rate Reduction Application in Long-Term Care - Document List Required for Assessment of Resident EligiblyTo 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 have a Notice of Assessment.014-4406-87
Request for an Unlisted Drug Product - Exceptional Access Program (EAP)For faster decisions, prescribers can use the SADIE online portal to submit requests to the Exceptional Access Program (EAP). Sign in through GO Secure (https://www.ebse.health.gov.on.ca) and select SADIE from the services drop-down menu. Visit the SADIE website for more information: http://www.ontario.ca/sadie. Alternatively, this form can be used for submitting requests to the EAP by fax.012-1993
Well Technician Licence Application - Form 4This form is for individuals interested in applying for a new Well Technician Licence or to add-a-class(es) to their existing Well Technician Licence, The licence is required to work at the construction of wells and expires on March 31 following the year of issue. Ontario Regulation 903 under the Ontario Water Resources Act prescribes the licensing requirements and outlines the roles and responsibilities for individuals/businesses and activities associated with wells.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.on00065
Application for a licence to carry out licensed activitiesA licence is required in order to operation a Fish processing operation that processes or packages fish products at a fish processing plant. A Fish processing plant could be a structure, boat, vehicle or vessel where a fish processing operation operates.006-3216
Direct Bank Deposit (Electronic Funds Transfer) Enrolment / Change of Information Third Party PayeesTo support direct bank deposit enrolment and information management for third party vendor records in Social Assistance Programs04-0201
Non-Agricultural Source Materials (NASM) Plan Registration FormTo register agricultural operations that intend to land apply Catergory 2 non-agricultural source materials (NASM) with a low metals content.006-fro-003
Request for Director's Statement of Arrears (Statement of Account)The Request for Director's Statement of Arrears is another term for statement of account. If a client wants to obtain a statement of their account, they must contact the Family Responsibility Office.The first statement of account will be free while any subsequent requests will be subject to a $25 fee.014-3134-84
Application For IVR ParticipationProvider/hospital applies for Interactive Voice Response to verify Health Card numbers via telephone003-atdia-005
Application To Upgrade a Machine Operator's LicenceAn application is required in order upgrade a machine operator's licence used to operate a tile drainage machine.004-0319
Vulnerable Victims and Family Fund RequestFor eligible victims of crime and their families who wish to apply for financial assistance and other supports available under the Vulnerable Victims and Family Fund.
