Please complete each section of the online request form (as applicable) to help process your request.

If you are not able to complete the form in one sitting, you have the option to click "save and continue later".

Your request will be processed once you click "submit" at the end of the form.

If you would like to retain a copy of your request, click "Download PDF"  BEFORE you click "submit".

If you have any questions about completing this form, contact:

A - Contact Information

*Name of Requesting Organization:

If your organization is not listed in the drop-down list below and you believe you are eligible for OODP Services, please contact the OODP Program Administrator at

*LHIN for Requesting Organization:

Please identify the Local Health Integration Network (LHIN) that services the area within which your main office is located.
Please type your responses below.
Telephone number:
Organizational website address:
Name of Executive Director:
Name of Chair, Board of Directors:

*Date of Request:

Please type your responses below.
Telephone number:
Download form including your responses to PDF Excel