If you have questions about how to fill out the form or would rather complete the form over the phone, please call us!
The information submitted via this referral form is transmitted by email to the Child Development Centre. While measures have been taken to ensure this information is received securely, any information transmitted via email is not secure or encrypted. The information contained in this referral form is also retained in a protected database on a server located in Canada for a maximum of 4 months, after which time it is deleted. If you would prefer an alternate method to submit the referral form, please call us at 867-456-8182 and we can complete the referral over the phone, or send you a paper copy.
Anyone can refer a child to the Child Development Centre. Parents, grandparents, aunts, early childhood educators, doctors, nurses and others. Ideally, we ask that if parents aren't referring their child directly, that the parents be informed of the referral.
Below is the form to sign-up for services. Once you have submitted the referral, you will receive a phone call within 2 weeks. If you have a question in the meantime, have trouble competing the form or have not received a call within 2 weeks of submitting the form, please contact us.
Si vous souhaitez remplir la demande consultation en français, veuillez télécharger ce pdf à remplir et l'envoyer par courriel à info@cdcyukon.ca.
If you live in Atlin, BC - please use this form (not the one below), once complete, email the form to reception@nwcdc.ca or fax it to 778-648-2032. You can also call us at 867-689-7170 to complete the form over the phone, or ask any questions.