Required fields are marked with asterisks (*)

Personal Services Setting Notification and Plan Review Form

Ottawa Public Health (OPH) is committed to working with new and existing business owners to prioritize the health and safety of patrons and employees.

In accordance with the Personal Service Settings, O Reg 136/18, please complete this form at least 14 days before commencing the operation.

Additional Infection Prevention and Control information can be found on our website, Personal Services Settings - Ottawa Public Health.

Should you have any questions, please contact OPH to speak with a Public Health Inspector at 613–580–6744.

Personal Services Setting Information

First Name of Owner / Operator:

Last Name of Owner / Operator:

Business Name:

Corporation Name (if applicable):

Business Street Address:

Business City:

Business Postal Code:

Business Phone Number:

Business Alternate Phone Number:

Business Email Address:

Business Fax Number:

Business Website:

Applicant Information

Notifcation Reason (check those that apply):

Addition of Services

Additional Businesses at this Location

Change of Location

New Business

Renovations

First Name of Applicant:

Last Name of Applicant:

Applicant Position:

Applicant Telephone:

Applicant Email:

Anticipated Opening Date:

Water and Sewage Services (check those that apply):

Municipal Water Supply

Municipal Sewage

Private Water Supply

Private Sewage

Type of Equipment:

Single-use (e.g. disposable)

Multi-use (e.g. re-usable)

Sterilizer / Autoclave

Type of Sinks:

Dedicated Handwashing Basin

Dedicated Reprocessing Sink

Please upload your site plan:

Browse…

Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

Additional Comments:

Form Builder

Personal Services Setting Notification and Plan Review Form

Personal Services Setting Information

Applicant Information

How Do I...?

Reporting something to Ottawa Public Health or returning a message

8-1-1 Health

2-1-1 Ontario

3-1-1 City of Ottawa