How to make a Referral

Referrals for services at Five Counties can be made in a number of ways. The easiest is to click on the icon below to complete our online Service Request Form:

Service Request Form icon


You can also make referrals by:

  • Phoning the Centre and speaking to our Central Intake Coordinator 705-748-2337 OR 1-888-779-9916 press 100.
  • Completing a Referral Form and sending by fax 705-748-3526.
  • Mail to our Peterborough office at 872 Dutton Road, Peterborough, Ont. K9H 7G1. Download and print a Referral Form.

When a referral is received it is reviewed and approved by the manager of the service. A referral may be prioritized based on a specific urgent need. Most frequently children are placed on a waiting list by date of referral. You will receive a letter indicating that the referral has been received and the estimated length of wait. Generally, the length of wait will be from a few weeks to months and is dependent on the service being requested.

Who can make referrals?

  • Families
  • Physicians / Nurse Practitioner
  • Other Agencies (Holland Bloorview or SickKids)
  • Community Partners

If you have questions, please give us a call: 705-748-2337 OR 1-888-779-9916 ext. 100.