Canadian Childrens Therapy

Occupational Therapy for Kids

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 in Years

City of Residence

Province or State of Residence

Name of Parents*

Parent's Email

Parent's Phone*

Leave a short message for CACt

* required information

Read more about our Therapy Services. 

Note: Please do not send medical information. Please call us instead.