Get Cti - Wpg Ref Form Mar 29 2016.doc

Filling out the CTI - Wpg Ref Form is an essential step in accessing various therapy services for children. This guide provides clear, step-by-step instructions to help you complete the form online with ease and accuracy.

Follow the steps to successfully complete the form.

1. Click the ‘Get Form’ button to obtain the form and open it in your chosen online editor.
2. Begin by entering the child’s information in the designated fields. Fill in the last name, first name, and birth date using the provided format (M/D). Select the child's gender by checking the appropriate box for 'Male' or 'Female'.
3. Provide a contact phone number for the child, along with their residential address, postal code, and city.
4. In the referral source section, input the primary language the child speaks, choosing from English or French, and indicate if an interpreter is required by selecting 'Yes' or 'No'.
5. Document the primary doctor’s name, designation, and contact information, including their phone number and address.
6. Indicate whether the family or caregiver has been informed about this referral by selecting 'Yes' or 'No'. Check the box to specify which parent or caregiver the child resides with.
7. If applicable, complete the section regarding legal guardianship. Provide the guardian's contact information and any agency names if relevant.
8. In the reason for referral section, check all applicable services that the child requires, including audiology, occupational therapy, physiotherapy, and speech-language pathology.
9. Fill in any additional comments regarding the child's diagnosis, presenting concerns, and any prior assessments.
10. Once you have completed all sections, review the information for accuracy. Finally, save your changes, download, print, or share the completed form as needed.

Complete the CTI - Wpg Ref Form online today to ensure your child receives the necessary support and services.