Business Reporting Form
(New, service changes, construction/renovation) revised Tuesday October 01 2019

As of July 1, 2018, the Personal Service Settings Regulation 136/18 requires every personal service business in Ontario to notify their local public health unit in writing of their intention to

Open a new business (please complete New Business Reporting form),
Provide additional service(s) to their existing business or
Reconstruct or renovate their existing business.

Please complete the questions below to report any new additional service(s) or plans to renovate an existing business:

Contact Information Contact Name Contact Phone Number Contact Email Address

Business Information Business Name Business Address Corporation Name Partnership Name Sole Proprietor Name Business City Municipal License Number/File Number Municipal License Expiry Date
Are you planning to offer a new service(s) to your existing business?
Yes
No
If yes, please indicate new service(s) added:
Are you planning any new renovations to your existing business?
Yes
No
If yes, please indicate what type of renovation you are planning:
Will services be offered during the renovation*?
Yes
No

*Renovation does not include routine maintenance or repair or replacement of existing equipment.

A public health inspector may contact you for further information about your change in
service(s) offered or your renovations plans.

For any questions, please contact Region of Peel Public Health at 905-799-7700 or by email.

Personal information collected on this form is collected under the authority of the Municipal Act, 2001 S.O. 2001 .c 25 s. 11 as amended. By submitting your application, you agree with the terms of use identified in the Notice of Collection.

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