Application for Northern Physician Retention Initiative - forms ssb gov on 2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by filling out your personal information in the 'Physician Contact Information' section. Include your last name, first name, middle initial, office address, and contact details.
  3. Indicate whether you have received other incentives or grants during the specified period. If yes, provide details including start and end dates.
  4. Answer questions regarding your hospital staff privileges and practice history in Northern Ontario. Ensure to attach any required proof of privileges.
  5. Proceed to the 'Declaration and Consent' section. Carefully read each statement and confirm your agreement by signing and dating the form.
  6. Review all entered information for accuracy before submitting. Use our platform's features to save or print the completed form as needed.

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