Prepared by: ODSP Branch
Date: June 2, 2006
Template Letter to Person Providing Support Services to the Household re: Caregiving
[Ministry Letterhead]
< Date>
To Whom It May Concern:
< > has indicated that <he/she> has an ongoing caregiving responsibility to a family member who is ill, elderly or disabled, and as a result of the caregiving, cannot participate in Ontario Works employment assistance activities (see reverse/attached for further details).
In order for < > to be excused from a referral to Ontario Works employment assistance activities, documentation is required from a person providing support services to the household stating that as a result of this caregiving responsibility, participation in Ontario Works employment assistance is impractical.
As a person providing support services to the household, please complete and sign in the appropriate section below, and return this letter to your patient/client.
Thank you.
< Name of ODSP worker >
This Section To Be Completed by a Person Providing Support Services to the Household (Please check one box only)
I, _____________________ (please print) am a person providing support services to the household. In my opinion, this person has an ongoing caregiving responsibility to a family member who is ill, elderly or disabled, and as a result, this person is:
? unable to participate in Ontario Works employment assistance activities
________________________________ _______________ ________________
Signature of Person Providing Support Services Profession/Occupation Date
? able to participate in Ontario Works employment activities as long as caregiving responsibilities are taken into consideration
_________________________________ _______________ ________________
Signature of Person Providing Support Services Profession/Occupation Date