Refer yourself or a loved one
Have you or has someone you love experienced a loss of vision that's impacting your mobility or independence? If you or a family member needs our support, we're only a few clicks away. Please fill out the form below as best you can, and one of our friendly and experienced client navigators will be in touch with you within 10 days on average, and less if we believe you are in a crisis situation.
We encourage you to complete all fields on this form so that we can build the best possible rehabilitation plan for you or the person you're referring; however, only those fields marked with an asterisk (*) are required. If you need assistance filling out this form, give us a call toll-free at 1-844-887-8572.
If you prefer, you can download and complete an accessible version of the Community Referral Form (PDF) and send it by fax to 416-480-7700.