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Service Information
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Service Information

Service:

Tel-Check
Organization: Family Counselling Centre
Description:

Tel-Check Program provides a daily telephone call to seniors and persons with disabilities who live alone. It offers emotional support and helps to ensure the individual’s safety. Calls are made 365 days a year.

Registrant Information

Registrant Name:

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Email Address:

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Phone:

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Secondary Phone

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Address:

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Is an interpreter required?

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Alternate Contact

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Alternate Contact Info:

Same contact information as Registrant

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Health Information

Reason for Referral:

e.g., New Diagnosis, Recent hospital admission, Caregiver burnout, etc..

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Additional Information

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Documentation:

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Notifications:

Send confirmation, change & reminder messages to < name> < email>

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Send confirmation, change & reminder messages to < name> < email>

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Submission complete

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Summary

Reference #: -

Registrant:
Organization:

Family Counselling Centre

Service:

Tel-Check

Inquiry Phone:

1 (519) 336-3000

Tip: Referrals can be viewed by navigating to referrals in the top menu

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