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Adobe PDF Adobe PDF document  Ontario Seniors Dental Care Program 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 & Save1182.0 kb
Form Classification
Classification / Identification:
 Form Number:014-5125-20EEdition date: 2021/06 
 Title:Ontario Seniors Dental Care Program Application
 Ministry:Health  
 Branch/ABC:Health Promotion  
 Program:Health Promotion  
 Purpose of Form:You may use this application form to apply for the Ontario Seniors Dental Care Program if you and your spouse (if applicable) have filed your Personal Tax Return(s) with Canada Revenue Agency (CRA) for the most recent tax year and have a valid Social Insurance Number (SIN). If you have a spouse (married or common law partner) who would also like to apply for the Program, they must complete their own application form.  

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