The purpose of this form is to provide an online reporting tool to submit claims for vehicle damage that were sustained while on a Provincial roadway. The report is for use by the general public.

This form is used by employers of workers in Type 2 or Type 3 asbestos operations. The form must be completed for each such worker at least once in each 12-month period and immediately on the termination of the employment of the worker. The form is submitted to the Provincial Physician at the Ministry of Labour. A copy of the completed form is given to the worker, and a copy is retained by the employer. Please note: When you select the link below, you will be prompted to create a My Ontario Account before completing the online form. If you already have a My Ontario Account, simply sign in using your existing login credentials.