Forms

Displaying 1 - 25 of 125
September 3, 2020
Use this order form for the From the Ground Up fundraiser for daycares.
September 3, 2020
This is the order form for the From the Ground Up fundraiser for schools.
September 3, 2020
Fill out this form to obtain adoption records in Yukon.
August 19, 2020
A doctor fills out this form after they finish a patient's mental health examination.
August 19, 2020
Fill out this application form to get or find a birth, marriage or death certificate issued in Yukon. Give this form to Vital Statistics.
August 14, 2020
Complete the Yukon Health Care Insurance Plan notification of extended absence form if you'll be away from Yukon for 6 months or more. Drop off this form at insured health services.
August 11, 2020
Fill out this form once you have returned from an extended absence from Yukon for 6 months or more. Drop off this form at insured health services.
August 5, 2020
Parents or guardians complete this form to consent or refuse consent of their child’s enrollment in the Yukon Children's Dental Program.
July 22, 2020
Use this template to develop an operational plan for your outfitting concession to address public health measures during the COVID-19 recovery in Yukon.
July 1, 2020
Yukon seniors who own or rent their homes can apply to the Pioneer Utility Grant (PUG) to get help with paying for home heating costs on their primary residence.
July 1, 2020
Yukon seniors who own or rent their homes can apply to the Pioneer Utility Grant (PUG) to get help with paying for home heating costs on their primary residence. For renters, this certificate is completed by the landlord and submitted by... more
June 17, 2020
You can use this form to apply for case management and outreach supports for housing and community outreach services. This applies to you if you: are homeless, or have a history of homelessness and/or housing instability; have complex... more
June 1, 2020
Fill out this form if you're no longer eligible for financial help due to your income. If this applies to you, talk to your social worker about transitional support. Give this form to your social worker.
May 15, 2020
Use this template to develop an operational plan for your business or service to address public health measures during the COVID-19 recovery in Yukon.
May 15, 2020
Use this form to request a review of your event or activity by public health professionals.
May 14, 2020
Use this out-of-country claims form to provide information for travel insurance or extended health benefits to make a health care insurance claim for services provided outside of Canada.
March 5, 2020
A physician uses this form. It confirms that a mother allows the collection of medical and personal information about her fetus's birth defect.
March 5, 2020
Environmental Health Services uses this form to document follow-up information on reported instances of rabies exposure. This information is sent to the medical officer of health and the chief veterinary officer.
March 1, 2020
Use this form to report incidents or issues on behalf of clients or residents of continuing care facilities.
February 19, 2020
Use this form to register to become an organ donor.
February 17, 2020
Use this form to apply to find a new doctor in Yukon.
February 7, 2020
Use the disclosure veto and statement if you're an adopted person or birth parent. This form stops the sharing of information from: a birth certificate; or related adoption records.
February 7, 2020
Health care providers use this form to refer your patients to the Chronic Conditions Support Program. These include: Your Health! Your Way!; Diabetes Wellness Series; supervised exercise; and Pulmonary Rehabilitation Program.
February 7, 2020
Use this form to submit batches of drinking water samples for bacteriological analysis to Environmental Health Services. They determine if water samples are within quality control parameters.
February 7, 2020
Municipalities, First Nations, Government of Yukon, and other businesses or organizations use this form to apply for a permit for a trucked drinking water distribution system. Environmental Health Services ensures that trucked water meets... more