Select this option if you or another physician not involved with Niagara Children’s Centre made a diagnosis that may result in a need for additional paperwork, funding applications, community referrals, or family adjustment/coping concerns (e.g. ASD diagnosis, neurodegenerative diagnosis).

Initial referral must come from physician specializing in physical, orthopedic, neurological or neuromuscular medicine, or checking this box will initiate PT Ax to determine eligibility.

Initial referral must come from physician specializing in physical, orthopedic, neurological or neuromuscular medicine, or checking this box will initiate PT Ax to determine eligibility.

ASD Assessment/Pediatric Neurology Clinic /Neurodevelopmental Clinic/Physical Medicine and Rehabilitation.