How to authorise or cancel a representative for the Seniors Dental Care Program — and autofill it with my-id.ca
Authorise a representative for the Seniors Dental Care Program — fill your details fast
The Ontario Seniors Dental Care Program lets you designate another person to act on your behalf, and the authorisation form asks for your personal details alongside the representative's information. This guide is an example of storing your details in my-id.ca so your section fills quickly.
Official form and source
Start from the official source and always use the current version — form numbers and links can change:
- Service page: Ontario Seniors Dental Care Program — ontario.ca
- Form (Central Forms Repository): Ontario Seniors Dental Care Program — Authorizing or Cancelling a Representative — 5127
What this form is about
This form allows you to authorise someone — such as a caregiver, family member, or trusted person — to communicate with and act on your behalf for the Ontario Seniors Dental Care Program. It also allows you to cancel an existing authorisation.
Before you start: what to gather
- Your full legal name, date of birth, and Ontario health number.
- The representative's name and contact details.
Confirm the current requirements and submission process on ontario.ca.
How my-id.ca makes it faster
- Store your details once. Add your name, date of birth, and health number to my-id.ca — the same details on the program application and other dental forms.
- Autofill your section. Use the my-id.ca Chrome extension on a web form, or fill a PDF from your saved profile inside my-id.ca.
- Add the representative's details — specific to this authorisation.
- Review and submit following the program process.
Why do it in my-id.ca
Seniors Dental Care Program participants may file multiple forms — the application, the guarantor application, change of information, and representative forms. Stored once in my-id.ca — in Canada, with self-hosted AI — your personal details fill every related form.
Frequently asked questions
- What does this form do?
- It authorises someone — such as a family member or caregiver — to act on your behalf for the Ontario Seniors Dental Care Program, or cancels an existing authorisation. Your personal details and health number are required.
- What details does the form ask for?
- Your name, date of birth, Ontario health number, and the name and contact details of the representative. my-id.ca can store your personal details for autofill.
- Is there a similar form for Healthy Smiles Ontario?
- Yes — Healthy Smiles Ontario has its own authorise or cancel representative form (014-4955-64). This form (5127) is specifically for the Ontario Seniors Dental Care Program.
Fill it once. Reuse it everywhere.
Save your information in my-id.ca once, then autofill this form and the next one — web forms with the Chrome extension, PDFs right in the app. Your data is stored in Canada and AI runs on my-id.ca's own servers, never sent to third-party AI providers.