|Classification / Identification:|
| ||Form Number:||014-0327-88||Edition 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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