Refer a Child We are taking new Occupational Therapy Patients: We only need contact info to get started. Please complete this form and we will call the family. Who is making the referral : Your Name* Your Title Your Organization Your Phone Number Your Email* Child you are referring: Name of Child Childs age City of Residence Province or State of Residence Name of Parents* Parent's Email Parent's Phone* Leave a short message for CACt [recaptcha] Read more about our Therapy Services. Note: Please do not send medical information. Please call us instead.