-
019-0230
Notice of Intention to Retain Interest in Surrendered Mining LandsIf a client holds a mining lease or patented mining land and wants to convert all or part of the land back to a mining claim, they use this form.014-4860-84
Vendor Application for Conformance Testing-Acceptable Use PolicyForm outlines the Conformance Testing-Acceptable Use Policy and is part of agreement between ministry and vendor who must successfully pass the conformance testing.016-1950
Working at Heights Training Provider ApplicationThis is the training provider application form a training provider must complete and submit to the Chief Prevention Officer, pursuant the authority under subsection 7.1(2) and 7.2(2) of the Occupational Health and Safety Act (OHSA), for the purpose of the CPO approving the training provider to deliver an approved working at heights training program.007-11383
Affidavit of Solvency (Amalgamation), Co-operative Corporations ActAn affidavit regarding the solvency of each of the amalgamating co-operative corporations. This form must be submitted along with the Articles of Amalgamation.014-3266-54
Application for Reduction of Assessed Co-payment FeesThis form is to be used for a patient who is seeking a reduction to the co-payment or for whom a reduction is sought further to the factors set out in section 10 of Reg. 552 under the Health Insurance Act.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 provided012-2030
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.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.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 claims012-2034
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 419/054872
Supporting Information for a Maximum Ground Level Concentration Acceptability Request for Compounds with No Ministry Point of Impingement (POI) Limit Supplement to Application For Approval, EPA S.9This form is used when a contaminant with no Ministry POI Limit is identified as apart of an Emission Summary and Dispersion Modelling (ESDM) Report.014-2404-84
Claims Flagged for Manual Reviewform submitted with claims to provide additional information regarding particular claim014-4311-82
Health Card Re-RegistrationForm is generated by client communication system to have people replace red&white card with photo health card2159
Renewable Energy Approval Site Plan Approval and Buidling Permit RequestThis form is intended to standardize the way in which applicants of wind facilities request copies of site plan approvals (issued under section 41 of the Planning Act) and building permits (issued under s. 8 of the Building Code Act, 1992) from municipalities when they are planning their projects.
