Access to Personal Information / Disclosure Form

If you are currently receiving services from Oxford CAS or have in the past, and would like access to your personal information, please complete our Access to Information/Disclosure form (*form opens in new window and submitted on website).

You must attach one copy of valid government-issued photo identification along with your request, and a photograph of you holding your government-issued photo identification. Alternatively, please attach one copy of valid government-issued photo identification along with your request, and a brief virtual meeting or in-person meeting will be scheduled prior to releasing the records to you.

Please see the attached Policy for further information about Identity Verification – Identity Verification Process for Individuals Requesting Access to Records of Personal Information.

Please note, the written consent of any person age 16 years and older is required to release their information to you. If you wish to obtain the personal information of any person aged 16 years or older, please email  disclosure@casoxford.on.ca and request a Consent to Disclose Information form.

A person who is a Substitute Decision-Maker for a child under the age of 16 may request personal information of that child, subject to some exceptions. In some circumstances, you may be asked to provide documents confirming your authority to make the request in place of the child.

"*" indicates required fields

Do you identify as First Nations, Inuit or Métis:
Oxford CAS continues to be committed to working alongside the First Nations, Inuit, and Métis communities in Ontario, in accordance with the Act Respecting First Nations, Inuit and Métis Children, Youth and Families, to prioritize cultural connection and services for families, children and youth. In following through with child welfare commitments to the Indigenous community we are asking questions about Indigenous heritage to ensure information provided is equitable and culturally sensitive supports are provided.

Purpose of Request:

Please choose one:*

Personal Details

Name*
Date of Birth*

Personal Contact Information

Address*
Preferred Phone Number*
Add Child
If applicable, please list other individuals about whom you are requesting information (Note: the written consent of any person aged 16 years and older is required to release their information and must be included with your request to obtain their information):
First Name
Middle Name
Last Name
Date of Birth (DD/MM/YYYY)
 

Request Details

If possible, please provide additional details regarding the reason for your request as this will assist us to provide you with the information you require.
Additional Information

Please attach information to support your request.

Max. file size: 300 MB.
Max. file size: 300 MB.
Max. file size: 300 MB.
Max. file size: 300 MB.
Confirmation & Consent*
Confirmation & Consent Checkbox 2*
Confirmation & Consent Checkbox 3*
Confirmation & Consent Checkbox 3

Concerned about a child or youth? Call us 24/7 519.539.6176 | 1.800.250.7010 What happens when I call?