Online Referral to KidsAbility

Change log

2025-03-17 robv: adding updates for Professional requests; removing HCCSS Transfer & OEYC Transfer options (moved to primary care specific roles as OHaH & EarlyON); fix province, same address mapping 2024-11-15 molly: updated consent on page 5, changed confidentiality statement to policies & procedures and updated hyperlink 2024-10-03 robv: contact info page, add calculations to enable 'same address as child' to map actual addresses to Legacy for both parents
2024-08-21 robv: toggle on 'Hide from answers dataset' for page 2 calculations group. Fix placeholders on addresses, add postal code mask. 2024-07-23 robv: add OEYC Transfer option & logic

Welcome to the Online Referral Form for KidsAbility.

KidsAbility is a SmartStart Hub for Waterloo Region, City of Guelph, and Wellington County. We provide a range of therapy services to children and youth aged birth to 18 (or until age 21 if attending a publicly funded school in our area).

As a SmartStart Hub, we support and connect families with concerns related to their child’s development and day-to-day functioning. Depending on a child or families’ needs, services may be provided by KidsAbility or by other community Partner Agencies.

More information for professional referral sources

Who should complete this online referral form?

As a SmartStart Hub we can support families with concerns about their child’s development who:

Are not sure what their child’s development needs, what services to seek or are not sure where to start.
Feel they would benefit from a discussion about their child’s development/strengths/needs.
Feel they would benefit from referral(s) to appropriate services, and access to family education and family supports.

Primary care providers/physicians, community partners, other professionals or someone helping a parent or guardian fill out the form may also submit the online referral form on behalf of a child/family with their consent.

What to expect: Parents

What to expect: Professionals

Language/Interpreter or Other Support Needs

To Begin:

^*What is your relationship to the child?

^*Has a parent or legal guardian with custody consented to this service request?

calculations

[user-type]

KidsAbility uses 'parent' (legal guardian & Form Helpers), and 'professional' (primary care provider, school rep)

[show-earlyon]

'yes' only for Provider/EarlyON referrals

[show-services]

Not showing Service dropdowns on pg 2 if EarlyON or H4K is selected in the 2nd role dropdown

[relationship-organization]

Used on Referral info page to word the question nicely

[link-to-private-practice]

Used in multiple places so only need to update it here