Surrey Clinic location:

Intake Form - Surrey Clinic

Please complete the following intake form to initiate the referral process. Upon receipt, our clinic coordinator will contact you by email (unless you request differently) to complete a referral form. Once this referral form is complete and received by us, you will be placed on our waitlist.*Please note: For Autism Assessments, there may be an 8-10 month wait at our Surrey location
* Please note, we cannot guarantee the confidentiality of information transmitted through e-mail including the intake form.  Please be aware of this limitation when contacting us.
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