Request for Services
To request services, please fill out our Request for Services Form . This form can be filled out by an individual requesting services or their parent or guardian. It can also be filled out by a health care or service provider but must still be signed by the individual, or in the case of minors, their parent or guardian. The information collected in this form is for the purpose of determining eligibility for service delivery and programming offered at the Centre for Behavioural Studies (The Centre). Once completed, please email the signed form to email@example.com or mail the form to:
Centre for Behavioural Studies
100 Portsmouth Avenue
Kingston, ON K7L 5A6
We will contact the individual or parent/guardian once we have reviewed the form.