Referral Form
If you would like your child to be referred to Lansdowne Children's Centre, please fill out the following form and, when complete, press the submit button. Please review program explanations and eligibility to assist you in determining the appropriateness of the referral. Please provide as much information as possible to assist in the processing of your referral. All information is confidential and secure and will not be used by anyone other than Lansdowne Children’s Centre for the stated purpose. Service Coordination and Social Work referrals cannot be made independently of other services. Referrals to the Early Autism Program are completed by Contact Brant.
If you prefer to print the Lansdowne Children's Centre Referral Form for completion at a later date you may use the links below to download the file in either of the two formats provided or simply print this page.
LCC Referral Form - Adobe Acrobat (56kb)
LCC Referral Form - Microsoft Word (52kb)
LCC Referral Form - Adobe Acrobat (56kb)
LCC Referral Form - Microsoft Word (52kb)
Please Note: Fields with an asterisk (*) are required.