Niagara Children's Centre - Service Request

Getting Started

Si vous désirez un service en français, veuillez communiquer avec les coordinateurs d’acceuil centrale à Niagara Children's Centre afin de compléter l’outil de vérification et de faire une demande de service par téléphone (905-688-1890 ext. 168).

On this form parents, primary care providers and professionals can refer to the Infant and Child Development Program.

At this time, all other services can be referred to via the existing referral portal as per instructions here: https://www.niagarachildrenscentre.com/referrals

Please call the Niagara Children’s Centre Intake Coordinators at 905-688-1890 ext.110 if you:

  • Are unable to complete the form in English (Where possible, complete as much as you are able in English. All responses will be verified with an Intake Coordinator and an Interpreter during the Intake Call, if an interpreter is requested).
  • Require other assistance to complete this form.

What to Expect:

  • Complete this service request in just a few moments.
  • Your answers on the Eligibility Checklist(s) may or may not result in a recommendation for referral based on the responses.
  • If a referral is submitted, the parent/legal guardian may receive a confirmation email that the referral has been received by the Niagara Children’s Centre and this email may contain information about next steps.
  • You can download a copy of the referral(s) for your records at the end of this process.