Personal Service Settings Client Records

Download this template to use for collecting records related to maintaining client records.

Ontario Regulation 136/18 Personal Service Settings states that owners/operators of personal service settings must collect contact information for clients receiving a service in their premises. All fields must be filled out completely for each client.

Records must be kept onsite for at least 1 year, and in a secure location for 2 years afterwards.

DATE

SERVICE

NAME

CONTACT INFO

Date of service:

E.g. July 1st 2019

Type of personal service:

E.g. hair cut

First and last name:

E.g. John Smith

Contact information:

E.g. 519-123-4567