Region of Waterloo Form

Required fields are marked with asterisks (*)

New Food Premises Notification Form

 The Health Protection and Promotion Act (1990) requires that anyone who intends to open a food premise must notify the Medical Officer of Health and all food premises must be in compliance with the Ontario Food Premises Regulation 493/17.

Please complete this form and submit a copy of the proposed floor plan.

Food Premise Information

Owner Information

Opening Information

Floor Plan


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Note: Food premises serviced by private water supplies are subject to the requirements of the Safe Drinking Water Act, 2002 and its accompanying Regulations. Private sewage systems are subject to the requirements of Part VIII of the Ontario. Please contact the respective township for Part VIII private sewage systems.

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