Referral Form2018-07-23T15:42:19+00:00

Download Referral Form

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Download our referral form and fax or mail it to ACO. Referrals will be accepted from healthcare professionals, community agencies, family members, friends or people with aphasia. Please fax the completed referral form to (613) 567-8930 or hand-deliver to 2081 Merivale Rd, Suite 300.

See below for a detailed description of our intake process.

Referral form (English)
Referral form (Fran├žais)

Intake Process for Aphasia Centre


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