Make a Referral

Contact and Referral Information

If you have questions or need assistance in understanding our services, our helpful staff is just a call away. Dial 519-354-0520 and press 0, and we’ll be more than happy to assist you!

Services Overview:

Not sure about which service suits your needs? Our staff can answer your questions and guide you through our offerings to find the best fit for you.

Referral Forms:

To initiate services, please complete the appropriate referral form below and submit it to our Centre.

General Referral for Children’s Treatment Centre of Chatham-Kent:

School-Based Rehabilitation Services:

SBRS Principal Referral Form (Must be completed and attached to program checklist below.)

Occupational Therapy


Speech Therapy

Central Auditory Processing

Coordinated Service Planning (CSP):

Referral from Community Service Provider

Augmentative Communication Services (ACS) Clinic:

For detailed information and consultation requests, please refer to the following documents:

For ACS consultation requests, please email the completed form to or contact us at 519-354-0520 for further assistance.

Fetal Alcohol Spectrum Disorder Program (FASD):

Referral from Community Service Provider:

Client Funded Services:

For information regarding Purchased Services for Occupational Therapy and Speech/Language Therapy, please contact Marnie Ball at 519-354-0520, ext. 243.

Thank you for considering the Children’s Treatment Centre of Chatham-Kent. We look forward to assisting you on your journey.