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OTHER DOWNLOADS                               FAMILY INTAKE                                TENDING THE FIRE
Applications
Tel. 519-289-0148    Fax. 519-289-0149   Toll free 1-800-328-2616
EAGLE WATCH CRISIS INTERVENTION 519-289-9090
TENDING THE FIRE APPLICATION
(PDF Format)

Download, fill out and fax back
FAMILY APPLICATION
(PDF Format)

1A - Initial Profile
1B - Shareholder Information
1B2 - Shareholder Information, Pt. 2
1C - Shareholder's Children Information
1C2 - Parent/Guardian Information
2A - Health Questionnaire
2A2 - Negative Cognition Questionnaire
2B - Release of Information Form
Items to Bring

Please complete all forms
and fax to:

Tracey Whiteye: (519) 289-0149

UPON RECEIPT AND REVIEW OF THE
APPLICATION she will contact you
to SCHEDULE a telephone interview
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