Referral Information and Forms

CTN provides service navigation and referrals to various programs and services (including ABA intake) throughout Simcoe County and York Region. If you think a family you work with needs to access any of CTN’s services, all you need to do is make the referral and we will do the rest.


Physicians

If you're a physician and think a family you work with needs to access our therapy, assessment or speciality services please complete the Physician Referral form.


Other service providers
 

For other service providers (therapists, early interventionists, resource teachers, etc.) CTN categorizes referrals in two ways:

1. Request for Local Team Services. Use this form to refer to:

  • Audiology 
  • Augmentative & Alternative Communication (Local Team Level) 
  • Brief Resource Service
  • Child and Family Counselling
  • Family Mentor Program
  • Feeding (Local Team Level)
  • Growth and Development Clinic
  • Inclusive Recreation 
  • Occupational Therapy
  • Physiotherapy 
  • Seating (Local Team Level)
  • Service Navigation; Service Navigation for Military Families
  • Single Plan of Care Coordination

2. Request for Specialty Services. Referrals to the services listed below require additional documentation and can only come from the providers and physicians listed in the form for each of the services. Please note this referral form does not include Feeding (FACS):
  • Augmentative and Alternative Communication (ACCS) 
  • Developmental Assessment (DACS) 
  • Seating and Mobility (SEAT) 
  • Joint Management Botox©/Baclofan (now referred to as Spasticity Management)
  • Neuropsychology 
  • CTN Medical Consult

3.  Request for Feeding (FACS). Please complete this form to make a referral to the Feeding (FACS) program.

Applied Behaviour Analysis (ABA) Intake Forms


Families and Providers: To access the provincially funded ABA program in York Region or Simcoe County, please use the forms below:

1. Accessing ABA services for the first time? Use this form- Initial ABA Services and Support Intake Form.
2. Accessing additional rounds of ABA for a child? Use this form- Repeat ABA Service Intake Form.

For more information about the Ontario Autism Program visit the Ministry’s website and Autism Ontario.


Need more information?

Call us at 1-866-377-0286
Our service navigators are available to help service providers as well as families. 
CTN recognizes the diversity of the communities we serve. Service navigation can be provided in French and we are happy to arrange for a translator for other languages.


Consent to Share Information

To discuss consent to share information with clients and families please review the Consent and Privacy Guide with the family and complete the Consent for Information Sharing and Collection of Personal Information form in the guide.  This will facilitate the sharing of information and the use of the shared record across all providers working with the child, youth and family

All completed forms can be faxed to CTN ACCESS at 705-792-2775.

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