Independent Health Facilities

Forms

IHF forms are currently under review. If you do not see a link to the form that you are looking for on this page please contact the program area at 613-548-6637.

Physician IHF Affiliation Authorization Form (new)

When the IHFP receives a request to affiliate a physician to an IHF, the IHFP will be reviewing the physician's qualifications prior to processing the affiliation. This may require the IHF and/or the physician to provide additional information for review by the ministry or College of Physicians and Surgeons of Ontario (CPSO). The licensee should not allow a physician to provide services within the IHF until the qualifications have been confirmed. The IHFP will only accept the revised version of the Physician IHF Affiliation Authorization document from this date forward.


Application for Consent to Transfer a Licence (revised)

The Application for Consent to Transfer a Licence must be submitted when requesting the Director's decision regarding the sale of an IHF. This application must be signed by the current licensee and the proposed purchaser. No transfer of ownership of a licence can take place without the prior written consent of the Director of Independent Health Facilities.


Quality Advisor Acknowledgement Form (new)

The Quality Advisor Acknowledgement form should be submitted with a copy of the Notice of Appointment of Quality Advisor Form when requesting a change in the quality advisor for an IHF. This form must be signed by the IHF quality advisor and the licensee.


Notice of Appointment of Quality Advisor Form (revised)

The Notice of Appointment of Quality Advisor form must be submitted with a copy of the Quality Advisor Acknowledgement form when requesting a change in the quality advisor for an IHF. This form must be signed by the IHF quality advisor and the licensee


For More Information

If you have any questions or concerns regarding the information provided on this webpage please contact the Independent Health Facilities Program at 613-548-6637.