We offer a wide range of services for children and youth. Although anyone can make a referral, some services do have specific referral criteria. Feel free to contact us to talk about you/your child's needs and we’ll help you get started. You can make a request for service by calling, or by mailing, faxing or securely uploading a completed referral form for the type of service you need.
Get Started
If you want to access services at TVCC, contact one of our Intake Coordinators:
- 519.685.8716 (in London calling area)
- 1.866.590.8822 ext 58716 (Toll free)
OR - 1.866.590.8822, Press 1 for Autism and Behavioural Services.
Or, make a referral by completing and sending in the referral form for the services you want.
Make a Referral
After selecting the referral form(s) set using the buttons below, be sure to download and save the form to your computer before filling it out. Caution: Opening and filling in forms inside your web browser window may lead to losing any information entered. Once you've completed your form(s), you submit the referral form using your preferred method described at the bottom of this web page.
TVCC General Referral
includes Autism & Behavioural Services
Preschool Speech & Language
School Therapy Services
Save a copy to your computer before completing the appropriate form below to make a referral for services through TVCC. You can submit your completed form by secure upload, fax or mail. Details are provided at the bottom of this page. If you need to refer for Preschool Speech and Language (PSL) or School-based Therapy Service, please select the appropriate button above to access these forms.
Save a copy of the form below to your computer before filling it out to make a referral for Preschool Speech and Language services (overseen by TVCC). You can submit your completed form by secure upload, fax or mail. Details are provided at the end of the form and at the bottom of this page.
Save a copy of the relevant forms below to your computer before having your school principal complete and submit the referral for School-based Therapy service including OT, PT and SLP. Completed forms can be submitted by secure upload, fax or mail. Details are provided at the bottom of this page.
School Principal / LRT
AND appropriate form(s):
Make a referral to Developmental Resources For Infants (DRI)
Submit Your Referral
After saving the form to your computer , you can submit completed forms by:
- Uploading your completed saved form through our secure upload link.
(Your referral form is encrypted as it is uploaded using sync.com service).
- Watch this short video demonstration of how to upload your completed / saved form. (Youtube Video 0:44 seconds)
- Printing and then faxing the completed forms to 519.685.8705, or
- Printing and mailing forms to:
Thames Valley Children's Centre
779 Base Line Road East
London ON N6C 5Y6
Attention: INTAKE
Request a Report
Clinical reports can be obtained with the consent from the client, parent or legal guardian. Please send requests along with corresponding consent to:
Clinical Information Services
Thames Valley Children's Centre
779 Base Line Road East
London, ON N5C 5Y6
Fax: 519.685.8705
If you need more information about requesting a report, please call 519.685.8716
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