Centre and Home Based Services Interest Form

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Information Collection Notice: This intake form is used to determine suitability of service and prepare for our initial contact with you.

The following information will be used to inform recommendations for the optimal learning environment for your child. Please answer each question as best you can.


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By submitting this form, you are consenting to receive marketing emails from: Kinark Child and Family Services, 7271 Warden Ave, Markham, ON, Ontario, L3R 5X5, CA, http://www.kinark.on.ca. You can revoke your consent to receive emails at any time.
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