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Welcome to the Fred Victor CDSS Referral Form

1. Please select which area you would like to refer your client

a) Click the link below to access the full CDSS Referral Form

Full CDSS Referral Form

OR

b) Click the link below if you are only accessing Trauma Services or Reaching Out to Women (ROW).

Note: Both of these services can be accessed as part of the full CDSS referral if more services are needed but to qualify to access trauma services and/or ROW, the same level of social/medical complexity is not required.

Trauma Services and ROW CDSS Referral Form

 

2. Please download the CDSS Consent Form and fax it to (416) 364-8526

CDSS is committed to ensuring that personal information is protected from unauthorized access, unintended disclosures or theft. To protect privacy, CDSS follows the requirements established by the Ontario Personal Health Information Protection Act (“PHIPA”).