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DET OHT Team Member Application 2024
3.
Contact Information of Applicant
*
1.
Name of Applicant Organization:
(Required.)
*
2.
Name of Contact Person (Representative) of Applicant Organization:
(Required.)
*
3.
Email address of Contact Person/Representative of Organization:
(Required.)
4.
Organization Type
Community Care Health Service Provider (CSS)
Community Health Centre
Emergency Health Services & Community Paramedicine providers
Family Health Team
Home Care Service Provider Organization (SPO)
Long-Term Care Home
Mental Health and Addictions
Municipalities
Paramedicine Provider
Other (please specify)