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Adobe PDF Adobe PDF document  Healthy Smiles Ontario - General ApplicationThe file you are about to download will ONLY work properly if opened with an Adobe Reader 10 or later client. Please do not open this file in a browser.Fill, Print & Save1409.0 kb
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Classification / Identification:
 Form Number:014-4953-64EEdition date: 2020/04 
 Title:Healthy Smiles Ontario - General Application
 Ministry:Health  
 Branch/ABC:Public Health  
 Program:Public Health  
 Purpose of Form:Healthy Smiles Ontario General Application form for the core services stream of the program. This form applies to applicants that have a valid SIN and have filed a statement of income or a tax return with the CRA.  

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