Farmers' Market Vendor Notification Form

Please complete and submit this form before you begin to sell any food items at this location.

An initial inspection with a Public Health Inspector will be arranged with you on-site. Please retain a copy of this form for your records; you will NOT be mailed/faxed a copy.


  1. Every person who intends to sell food to the public must notify the Health Unit in accordance with Section 16(2) of the HPPA.
  2. This form may be forwarded to the Tobacco Enforcement Officer (TEO) to ensure compliance with the Smoke Free Ontario Act. If there are any concerns, the TEO will call the person(s) responsible. For more information on the SFOA, 2017, please contact:

Owner Information

Business Information

Type of Meat Being Served/SoldName of Licensed Meat PlantAddress of Licensed Meat PlantPhone Number of Licensed Meat Plant
Type of Eggs Being Served/SoldName of Egg Grading StationEgg Grading Station Number
Type of Food Being Served/Sold

The Personal Information on this Farmers’ Market Vendor Notification Form is collected under the authority of the Health Protection and Promotion Act and applicable privacy legislation. This information will be used for delivery of public health programs and services and may be used for evaluation or statistical/research purposes. Any questions about the collection of this information should be directed to:

SWPH Privacy Officer
1230 Talbot Street, St. Thomas, ON N5P 1G9
Phone: (519) 631-9900; Fax: (519) 631-3745