Forms

Displaying 1 - 25 of 145
February 16, 2024

Have this form filled out to be reffered to the family Resource Unit.

January 12, 2024

This form is to apply to the Food Literacy Grant for the Kids in the Kitchen and We Can Cook programs. Submit your completed form to the health promotion team in-person, by mail, email or fax.

November 16, 2023

This is a client feedback form to be completed by clients, family members, legal advocates and people informally supporting a client.

October 20, 2023

This is the RSV immunoprophylaxis program application form. It is to be filled out to enrol a high risk child.

September 21, 2023

School order form for 'From the Ground Up' 2023

September 21, 2023

From the Ground up early learning centre order form

September 8, 2023

Use this form to report incidents or issues on behalf of clients or residents of continuing care facilities.

August 10, 2023

Parents or guardians complete this form to consent or refuse consent of their child’s enrolment in Yukon Children's Dental Program.

July 25, 2023

Physicians use this form to report instances of rabies exposure to Environmental Health Services.

June 26, 2023

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 26, 2023

Complete this form only if you do not wish to submit a Notice of Assessment from the Canada Revenue Agency with your PUG application. Yukon seniors who own or rent their homes can apply to the Pioneer Utility Grant (PUG) to get help... more

June 13, 2023

Fill out this application to get a permit to install a sewage disposal system.

June 13, 2023

Fill out this form if you're the electrician responsible for electrical work for a property's sewage pump-up system. Give the form to the homeowner or to Environmental Health Services.

June 13, 2023

Fill out this form if you're responsible for inspecting and maintaining a septic system and soil absorption system. Give this form to Environmental Health Services once it's filled out.

May 30, 2023

Use this form to submit a bacteriological analysis of drinking water.

March 24, 2023

Request a list of patients who may need to switch to a biosimilar medication.

March 20, 2023

Use this form to apply to find a primary care provider in the Yukon.

February 20, 2023

Fill out this form if you want to be a marriage commissioner in Yukon. Give this form to the vital statistics office.

February 14, 2023

Fill out this form if you plan to install and maintain a sewage holding tank.

February 14, 2023

Fill out this form within 30 days of installing your sewage disposal system to prove it's Canadian Standards Association (CSA) certified.

February 14, 2023

Fill out this form if you're the electrician responsible for electrical needs for a sewage holding tank. Give the form to the homeowner or to Environmental Health Services.

January 23, 2023

This form is to report a respiratory outbreak to Yukon Communicable Disease Control. It's to be filled out by health professionals.

January 23, 2023

This is the staff line list for respiratory outbreaks. It's to be filled out by health professionals and submitted to YCDC.

January 23, 2023

This form is the resident line list for gastrointestinal outbreaks for health professionals. They will fill it out and submit it to YCDC.

November 25, 2022

This is the downloadable Edmonton Symptom Assessment System (ESAS-r).