Nanaimo, BC
Below are the common forms you might require for appointments.
[GP offices: click here to get referral forms. Please fax these to our office.]
Often we will ask that these be completed and returned before your appointment is booked. We encourage you to download them here from our web site. You can return them by fax, by mail, or in person.
Educational Assessments:
This form below may be required for appointments related to learning, possible ADD/ADHD, or even some behaviour concerns in older children. Below is also a consent form, which authorizes the school to share information with our office.
Please download these two forms. A parent or legal guardian must sign the consent form for your school. You can present each of these to your school for completion. The school can either return them to you, or send them directly to our office.
School Questionnaire (consent form included)
In cases being assessed for possible ADD/ADHD, we will often ask for the SNAP forms below. For these forms, you must complete two copies: one from the parent, and one from the teacher.
Developmental Assessments:
The form below is often required when we are seeing younger children for assessment of their development. This might include children with chronic illness, who may need ongoing care through our office. It is only completed once.
Please download the form below. It should be completed by a primary caregiver of the child. COmplete as much infomration as you can, and don't worry if many questions you are uncertain.
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Nanaimo, BC