Yukon Department of Health and Social Services Forms

This form is used for giving consent for school immunizations for students in grade 9 in Yukon, Canada.

This document is used to gain consent for immunizations for Grade 9 students in Yukon, Canada. It is available in French.

This Form is used for obtaining parental or legal guardian consent for a hearing screening test for students in Yukon, Canada. It is in French language.

This Form is used for obtaining consent to obtain personal health information from another organization or agency in Yukon, Canada.

This Form is used for obtaining consent to obtain personal health information from another organization or agency in Yukon, Canada. The form is available in French.

This form is used for applying for an HCOS Unit in Yukon, Canada.

This form is used for giving consent to Hearing Services in Yukon, Canada, to release personal health information to another organization or agency.

This document is used for obtaining consent to share personal medical information with another custodian or representative. It is specific to the Yukon territory in Canada and is written in French.

This form is used for reporting temporary absence in Yukon, Canada.

This Form is used for making out-of-country claims in the Yukon, Canada.

This form is used for out-of-territory medical travel via road to scheduled appointments in Yukon, Canada. It is used to request reimbursement for travel expenses incurred while traveling to medical appointments.

This Form is used for requesting reimbursement for medical travel expenses outside of Yukon, Canada.

This Form is used for submitting consultation requests in the Yukon, Canada.

This form is used for requesting consultation in Yukon, Canada. It is available in French.

This Form is used to gather referral information in Yukon, Canada.

Ce formulaire est utilisé pour la déclaration ou la recommandation dans le territoire du Yukon, au Canada. (French)

Ce formulaire est utilisé pour obtenir le consentement de la mère et du fœtus à la collecte de renseignements médicaux au Yukon, au Canada.

This form is used for reporting and referring cases of congenital anomalies in Yukon, Canada.

This Form is used for requesting access to personal information and personal health information records in the Yukon, Canada.

This form is used for requesting a record of user activity in Yukon, Canada.

This document is used for requesting a record of user activity in Yukon, Canada. It is available in French.

This document is a request form for accessing personal information or personal health information records in Yukon, Canada. It is available in French.

This form is used for obtaining consent to release personal information in the Yukon, Canada. It is available in French.

This form is used for granting consent to release personal information in the Yukon, Canada.

This form is used for medication agreements in Yukon, Canada. It ensures that patients understand and agree to the terms of their medication regimen.

This form is used for conducting an initial assessment in the Yukon territory of Canada. It helps gather information for evaluating a situation or condition.

This document is used for conducting the initial assessment in Yukon, Canada. It is written in French.

This document is used to formalize a professional agreement between a pharmacist and the Yukon government in Canada. It details the terms and conditions of this partnership. This form is available in French.

This form is used for a Pharmacy Agreement in the Yukon territory of Canada.

This Form is used for requesting accommodations in Yukon, Canada.

This document is a form for applying to become a Marriage Commissioner in Yukon, Canada.

This Form is used for changing the sex on the birth registration for individuals who are 16 years and older in Yukon, Canada.

This form is used for changing the sex recorded on the registration of birth for applicants under 16 years of age in Yukon, Canada.

This type of document is for changing the gender designation on a birth registration for individuals under 16 years of age in Yukon, Canada.

This document is for requesting a non-voluntary medical examination in the Yukon, Canada.