Introduction Link

Appendix A
Local Contacts and Services

Template for Local Contacts

This template shows the children’s services that provide either universal or specialized services to children.
Local contact information can be inserted into the spaces prior to printing the template.

18-months Flow Chart

18 Month Flow-Chart

Some communities in Ontario have an online link for local contacts and services, while others do not. If your community does not have an 18 months flow chart, use the above template to create one.

Template Referral Form

Some communities in Ontario have developed referral forms to assist with referring a child to another agency.
The purpose of these forms is to:

  • Assist professionals to decide which agency the child and family should be referred to
  • Assist with the process of collaboration between agencies
  • Assist with the communication between the referring agency and the receiving agency

Each community can adapt this form by entering the appropriate local services and contact information.
The form can then be printed as required.

Referral Form

          Form preview:  Referral Form