Referrals

Request Services

Anyone may request services on behalf of a child or youth, therefore we have created this electronic request form for your convenience.

 

You may also print out the referral form by clicking on the button below, and email it to [email protected]

Print Form
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  • MM slash DD slash YYYY
  • Max. file size: 100 MB.
  • Max. file size: 100 MB.
  • Max. file size: 100 MB.
    *In Quesnel, the SLP waitlist is shared by the Q&DCDC and the Northern Health Speech and Language Clinic. Initial intake will be conducted at the Q&DCDC, however, children being referred for SLP services may be assigned to either facility based on the soonest available opening. This does not affect any other service a child may require from the Q&DCDC.*
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