*Please note you must download/save to computer, then fill out, save and send.
Where do I send my connection (referral) form?
- Completed forms can be faxed to 250-723-7349 or emailed to firstname.lastname@example.org
- if you would like help completing these forms, please contact us at 250-723-1117.
How do I connect to the services?
- You do not need a doctor to refer you, you can call our office and refer over the phone.
- Parents, relatives, teachers, doctors, health care professionals, child care professionals can all connect to our services, but with parent or guardian consent.
- Many of our community partners, including daycares, doctors, public health nurses and other local agencies have copies of these forms and can fill the out on your behalf.