Healthy Smiles Ontario Parent Notification Form (PNF) Emergency and Essential Services Stream (EESS)
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Forms, Links, and Information
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English - 014-5034-64e - Healthy Smiles Ontario Parent...PDF
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French - 014-5034-64f - Healthy Smiles Ontario Parent Notification...PDF
Additional Information
Form Number | 014-5034-64 |
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Title | Healthy Smiles Ontario Parent Notification Form (PNF) Emergency and Essential Services Stream (EESS) |
Description | This form is to be used by Public Health Units after dental screening to notify parents/guardians that their child has an emergency and/or essential dental condition(s). Parents/Guardian will complete the form and return it to the Public Health Unit to let them know that the child has initiated treatment or to attest to financial hardship and enroll into the Emergency and Essential Services Stream of Healthy Smiles Ontario. |