• Mobile Dental Van Registration Form 免費牙齒護理服務登記表格

  • Free of Charge 費用全免

    Dental Care Service 牙科護理服務:

    Dental examinations & x-rays 牙科檢查及x光檢查
    Scaling 洗牙
    Fluoride treatment 氟化物塗層治療
    Sealants 窩溝封填
    Filings 補牙
    Extractions 脫牙
    Root canals 根管治療/杜牙根
    Partial/full dentures (reduced fees) 局部或全口假牙(優惠價)

     

    Eligibility 申請資格:

    Live in City of Toronto 於多倫多士居住
    Must not have private dental insurance 不持有任何私人牙科保健
    Enrolled in one of the following 正參與下列計劃:

    Ontario Works (OW)
    Non-Insured Health Benefits (NIHB)
    Ontario Disability Support Program (ODSP) 安大略省殘障支援計劃
    Ontario Seniors Dental Program (OSDP) 安省長者牙科保健計劃
    Interim Federal Health Program (IFHP) 聯邦臨時醫療保險

     

  • Birthday 生日*
     - -
  • Format: 0000000000.
  • Gender 性別*
  • Are you living in city of Toronto?(Please upload your proof of address) 你是否於多倫多市居住? （請上傳你的住址證明）*

  • Why Immigration, Refugees and Citizenship Canada (IRCC) collects personal information?
    為什麼加拿大移民、難民及公民部(IRCC)要收集個人資訊?

    You can access the notice issued by IRCC through the following link to learn more:
    你可以透過以下連結瀏覽由IRCC發佈通告知道更多:

    English version
    Traditional Chinese version 中文版本

    For details, please consult 詳情請瀏覽
    http://www.cic.gc.ca/english/department/atip/index.asp

     

  • Immigration Status in Canada 在加拿大的身份*
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  • Do you have any dental insurance?你是否持有任何牙科保險?*
  • Which of the following schemes are you enrolled in? 你參與以下那一個計劃？*
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  • Pre-service needs assessment  服務前需要評估

    In order to streamline the registration process, if you have previously received our services and completed the pre-service needs assessment, you may skip the assessment section. Otherwise, please take a few minutes to complete it so that we can provide services and activities best suited to your needs. Thank you!為了簡化登記流程，若你在2025年4月1日至今日曾報名參加我們的服務，又填寫過服務前需要評估，我們會為你略過評估；相反，我們邀請你花時間完成以下評估，以便我們能為你提供更適合的活動及服務，感謝！
  • Did you previously receive our services and complete the pre-service needs assessment? 你是否在2025年4月1日至今日曾報名參加我們的服務，又填寫過服務前需要評估？*

  • Pre-service needs assessment  服務前需要評估

    The following questions are to better understand your needs related to settling in Canada. The information collected will help us provide IRCC(Immigration, Refugees and Citizenship Canada) and non-IRCC funded services and make appropriate referrals.f you have any difficulty completing the form, please don't hesitate to call us for assistance. Thank you for your time.  以下問題是為了了解更多你在移居加拿大的需要，所收集的資料將會為家和提供包括加拿大移民、難民及公民部及非加拿大移民、難民及公民部資助服務及作出適當轉介。如果您在填寫表格時遇到任何困難，請隨時致電我們尋求協助。感謝您的寶貴時間。
  • Do you have any of the following to support your live in Canada?:以下那一項能支持你在加拿大的生活？*
  • Do you have any needs related to your living in Canada? 你在加拿大生活有沒有以下的的需求？*
  • Do you have any language-related assets?: 你是否具備以下語言相關的優勢？*
  • Do you have any needs related to language?: 你是否有任何與語言相關的需要？*
  • Do you have any assets related to Employment or Adult Education?: 你是否具備任何與就業或成人教育相關的優勢？*
  • Do you have any needs related to Employment or Adult Education? 你是否有任何與就業或成人教育相關的需求？*
  • Do you need any support services to participate in future settlement services? 你是否需要在未來的安居服務中需要以下支援？*

  • Consent 同意

  • Consent 同意 -- I agree to be contacted by e-mail and phone call 我同意工作人員將會通過電郵及電話聯繫我。*
  • I agree to be photographed, video-recorded and voice-recorded during the event for possible future use for CFSO publications, internet, and other print media and electronic media. 本人同意授權予家和在本活動中進行拍攝、錄影及錄音，以及同意授權相片及影像用於其刊物、通訊、及其他印刷媒體、電子媒體及互聯網。*
  • Should be Empty: