Referral Forms | Quinte Health Care Paediatric Clinic
Referral Forms

Download Our Referral Form

 

Referral Forms

Our referral form is now available online, please download here.

For all school aged behavioural consults, parents/caregivers are mailed three forms in total to be completed prior to an appointment being booked. Two forms are to be completed by the child’s teacher which includes the CADDRA Teacher Assessment Form and the CADDRA SNAP IV 26. The CADDRA SNAP IV 26 is also to be completed by the child's parent/caregiver. All of these forms together encompass a collaborative care tool that helps the Paediatrician to better assess the child and utilize the appointment time more efficiently.

Once these forms are completed and sent back to the clinic, an appointment is scheduled with the Paediatrician requested or whoever is first available.