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Adobe PDF Adobe PDF document  Application for Northern Health Travel GrantThe file you are about to download will ONLY work properly if opened with an Adobe Reader 10 or later client. Please do not open this file in a browser.Fill & Print1411.0 kb

Form Classification
Classification / Identification:
 Form Number:014-0327-88Edition date: 2019/01 
 Title:Application for Northern Health Travel Grant
 Ministry:Health and Long-Term Care  
 Branch/ABC:Northern Health Programs  
 Program:Northern Health Programs  
 Purpose of Form:Used to apply for financial travel assistance by Northern Ontario residents who must travel long distances to access medical specialist services.  
 Ordering Information:Submit completed order request form (form # 014-0350-93) to OSSDistribution@ontario.ca (preferred option) or fax to 416-679-8192.

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