TPS Vendor Notification

Temporary Personal Services Vendor Notification

Environmental Public Health
Instructions:
- Complete this form for each special event you attend.
- To save your progress, scroll to the bottom of any page and click SAVE.
- If you have questions, or need assistance, please contact us at 1-833-476-4743, visit our website, or reference the Personal Service Standards.
Event Details

Describe when and where the event is being held.
Event Name*
Event Address*

Street Address

Street Address Line 2

City / Town / MunicipalityProvince

Postal
In what area of the province is this event taking place?*

South ZoneCalgary ZoneCentral ZoneEdmonton ZoneNorth Zone
To find what zone the event is in, click the following link.
Event Organizer Details

Please provide details about the organizer of the event that you plan to attend.
Organizer Name*

First NameLast Name
Organizer Phone Number*
Please enter a valid phone number.
Organizer Email*
example@example.com
If the organizer provided you an alpha-numeric code for this event, enter it here:
This code is unique to this event. DO NOT use a code for a different event or your registration may be lost.

General Sanitation / Storage
Please confirm ALL of the following:*
Worker Hygiene

Sinks are important for hand hygiene. They must be easily accessible and be equipped with SOAP and PAPER TOWELS at all times.
What will staff and volunteers use to wash their hands during the event? (Select all that apply)*

Handwash sinks with hot and cold running water.Temporary handwash stations.Hand sanitizer at various locations inside the booth (Note that this option must be approved by the inspector in advance of the event if it is the only method available).
INFORMATION: An example of a temporary handwashing station may be found here.
Do workers understand the requirements for good personal hygiene, the need for clean personal attire, and the expectation that there will be no smoking, vaping or eating near the work area?*

YesNoN/A
IMPORTANT NOTE: workers must ensure proper hand hygiene is maintained and that their clothing is visibly clean at the start of service for each client.

	Provided by	Source	Other Details / Description
Electricity

	Provided by	Source	Other Details / Description
Potable Water

	Provided by	Source	Other Details / Description
Liquid Waste Disposal

	Provided by
Garbage Disposal
Sharps Disposal

Submission Page
Do you have any additional comments or details you wish to share with us?
File Upload Section

Please upload up to 5 attachments you have to support this application here. There is a 1MB size limit for each file.
Cancelof
Examples:
- Drawings or photos of your setup (if you have them)
- Any other document requested by your Public Health Inspector for the event
By entering my name below, I certify that the information on this notification is true and correct to the best of my knowledge.*

First NameLast Name
Please verify that you are human*
Once you click SUBMIT
- You will receive an email confirmation and a pdf copy of your Personal Services Vendor Notification (for your records).
- A copy will be automatically sent to the event organizer and AHS.
Please ensure that the Zone that you selected at the start of the form is correct to avoid processing delays.

IMPORTANT NOTE:
1. Applications must be received no later than 30 days prior to an event, AND
2. Edits to an application must be received no later than 14 days prior to an event.
Notifications (and changes) received later than the above may not be reviewed or approved by the department.

Should you have any questions, please contact us at: 1-833-476-4743
Should be Empty:

	Yes	No	N/A
1. The application of antiseptic products to clean skin or mucous membranes following a procedure.
2. Any accidental exposure to blood or body fluids.
3. Providing post-service care to clients.
4. The decontamination of sinks used for hand hygiene and/or equipment reprocessing.
5. The operation and set-up for mobile sinks.

Temporary Personal Services Vendor Notification