Contact Request

Please complete the Contact Request form below and someone from our Intake Team will get back to you.

Name (Person with ASD Diagnosis)*
First Last
Contact Parent/Guardian’/Decision Maker’s Name
First Last
Contact email address*
Contact phone number
Service Region*
If “other” was specified, please indicate your region or city below
Please choose only which Stream of Services and Supports you are inquiring about.
Please specify any specific services and supports you are interested in learning more about.
Group Services
Camp Options
Respite
Applied Behaviour Analysis (ABA) / Core Clinical Services
Parent and Caregiver Supports
Adult Supports and Employment Services
Learning and Development
Other