Referrals to Augmentative Communication Services (ACS) are accepted from parents, physicians, therapists, or community service providers with parent’s consent.

If your child has previously been seen in the Augmentative Communication Service for communication (speech) or writing aids and their equipment is no longer meeting their basic communication needs at home, please indicate this is a re-referral below.

Your responses to the questions below will help determine the most appropriate service for the person being referred.

What to Expect:

Complete this service request in just a few moments.

Once completed, the referral source and parent/legal guardian will receive a confirmation email that the referral has been received. The referral will then be reviewed by the Intake Team who will determine if the referral meets the clinic’s criteria. After this is determined, the referral source and parent/legal guardian will receive a letter letting them know if the referral has been accepted and the next steps.

For more information regarding our clinic’s criteria, please check out the “Augmentative Communication Services” section on our website.

Some sections of this referral form were adapted from Augmentative Communication Service at the Thames Valley Children’s Centre with permission.