Dental Program Forms
|As of January 1, 2016, HSO and CINOT will be changing into a new integrated program for children. This change will provide seamless enrolment and make it easier for children and youth to get free dental care.
Healthy Smiles Ontario (HSO) Program Enrolment Form and Memo
What is the Healthy Smiles Ontario (HSO) Program Enrolment Form?
- The Healthy Smiles Ontario (HSO) Program Enrolment Form is for families wishing to enrol their children in the Healthy Smiles Ontario (HSO) Program.
- The Healthy Smiles Program aims to improve the oral health of children and youth by providing access to preventive dental care for children from low income
families and therefore reducing the need for urgent
How will I get this form and what should I do with this form?
- Pick up and drop off your Healthy Smiles Ontario
Enrolment Form at any of these locations.
- You can also download the Enrolment Form online.
|Enrolment Form Checklist
|Before dropping off your form:
- Did you sign all three sections of the form: Section A, Section C and Section D?
- Did both parents (if parents are married/common-law) sign all three sections of the form: Section A, Section C and Section D?
Unfortunately, we are unable to process incomplete forms. If forms are incomplete, it will delay processing.
- Do you have all the required documents that you need to present?
What documents do I have to bring with me when I drop off my form?
- You will need to enrol in person at one of the Region
of Peel locations indicated and show the following documents:
- Annual Canada Child Tax Benefit and Ontario Child Benefit Notice OR Annual GST Credit Entitlement Notice (most recent tax year)
- Government issued identification (one of the following:
- Ontario Health Card
- Canadian Citizenship Card
- Permanent Residence Card
- Canadian Immigration Identification
- Ontario Drivers Licence)
- Child’s Ontario Health Card
What if I do not have all of the documents?
- If you do not have all the required documents
you may still be able to apply to the program,
call Peel Public Health at 905-799-7700 or visit
one of these locations.
Where can families access dental care as part of Healthy Smiles Ontario?
- Once a child qualifies for the Healthy Smiles Program, Peel Public Health will advise the family of the dental service options available.
- The client card is valid for up to one year, or up to the child’s 18th birthday, whichever is earlier.
My Healthy Smiles client card is almost expired what should I do?
- At least one month prior to the expiry date of your card, Peel Public Health will contact you via mail to provide the documents required for renewal or application.
What should I do if I lose my Healthy Smiles client card?
- Call Peel Public Health at 905-799-7700 as soon as
you realize the card is lost and we can arrange for a