Vendor Application Form for Special Events Offering Personal Services

This application form must be completed and submitted to the Windsor-Essex County Health Unit at least 30 days prior to the event

Step 1: Complete this application form

Step 2: Review the Checklist for Vendors Providing Personal Services of Special Events that offer Personal Services for more details on the requirements.

In addition to completing Steps 1 and 2, all vendors must comply with:

Event Information
Vendor Information
Booth Location
Types of services at this event (mark all that apply)
Multi Use Equipment Used at the Event
Will sharps, such as needles and razors will be used on-site?
All items that require sterilization such as needles, needle bars, jewellery, and forceps will be brought to the venue pre-packaged and sterile?

For items purchased pre-packaged and sterile, provide the contact information for the supplier

For items sterilized at a business location, provide the name and address of where the items were sterilized, if different from above

Single Use Disposable Equipment Used at the Event
(check all that apply)
Hand Hygiene
70% - 90% alcohol based hand rub will be available at the booth?
*All personal services workers must perform hand hygiene before service delivery and as required during and after service. The event organizer/coordinator is responsible to ensure there are hand wash stations and they are equipped with liquid soap in dispensers and single use towels for all vendors and their staff. It will be the event organizer/coordinator’s responsibility to maintain these stations fully equipped and in a sanitary manner at all times during the event.
Cleaning and Disinfection
Items will need to be cleaned and disinfected on site?
Labelled container(s) to store and transport dirty items will be available?
*Cleaning and disinfection sinks need to be conveniently located, large enough to fit the largest item and designated for the cleaning of disinfection of these items. Any exceptions must be discussed and approved by the inspector. If disinfection is necessary, soap, utility gloves, and a scrub brush may be required.
Appropriate disinfectant(s) are provided and labelled?

Please note that non-compliance with Windsor-Essex County Health Unit requirements may result in service interruption or closure.

Applicant: I have read the Infection Prevention and Control Checklist for Vendors Providing Personal Services at Special Events information sheet. I agree that all the information I have provided is accurate.


Source URL: https://www.wechu.org/vendor-application-form-special-events-offering-personal-services

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