English - 5128e - Ontario Seniors Dental Care...
You may use this form if you have applied and are enrolled in the Ontario Seniors Dental Care Program and would like to change the information provided at the time of application. Through this form, you can update applicant information, contact information, marital status and/or spousal information, income declaration, or withdraw consent to disclose personal information and/or personal health information.
Additional Information
| Last updated | June 28, 2024 |
|---|---|
| Created | December 11, 2021 |
| Format | application/pdf |
| Form Number | https://forms.mgcs.gov.on.ca/dataset/e27a6c29-01cd-44d5-b000-0cc465818c4b/resource/828b5c46-92d2-4770-925a-d739e2393873/download/5128-20e.pdf |
| Form File Identifier | |
| Name | English - 5128e - Ontario Seniors Dental Care Program. Change of Information |
| Form File Status | -- Please Select -- |
| Description | You may use this form if you have applied and are enrolled in the Ontario Seniors Dental Care Program and would like to change the information provided at the time of application. Through this form, you can update applicant information, contact information, marital status and/or spousal information, income declaration, or withdraw consent to disclose personal information and/or personal health information. |
| Language | English |
| Functionality | -- Please Select -- |
| Form File Content Type | -- Please Select -- |
| Remark | |
| Edition Date | 2024-05 |