Please include all individuals residing in the family home.
Please fill out any additional contact info that you think is necessary. Leave it empty if no additional contact is needed.
In order to access service funded by the Ministry of Children, Community and Social Services a diagnosis must be sent to us. In order to be considered a valid diagnosis it must include the following components easily visible in the scanned document.
• Client’s name• Client’s date of birth• Date of diagnosis• Must state: “Was found to meet the criteria of a diagnosis of Autism Spectrum Disorder” or “Meets DSM 5 criteria for Autism Spectrum Disorder (ASD)”• Doctor’s signature
If your diagnosis is password protected, please email the password to intake@autism.net
Select Yes, if you would like to receive email & e-newsletter about Geneva Centre for Autism. Your email address will be used strictly for contacting you in matters regarding Geneva Centre for Autism and keeping you informed about our activities.It will not be shared with anyone outside of Geneva Centre for Autism.