Referral Form

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Please Note:

  • The referral form can be completed by either a client, caregiver, health professional or educator with permission from the client/caregiver.
  • Please ensure you review our Fees & Payments page for relevant information prior to making your referral request.
  • If you run into issues with this online referral form you can contact our office to complete a referral over the phone.
  • At certain times throughout the year we may have waiting lists for particular regions. To find out if there are waiting times in your region please contact the office.