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