Champions accepts frequent referrals from community partners, please fill in the Referral Form above and fax to 403.265.5675 marked, Att: Intake or scan and email to: firstname.lastname@example.org
Please read carefully and note all of Champions’ eligibility requirements. All boxes must be checked and apply to the individual. After receiving this referral form, Champions will contact the individual directly by telephone.
Please note the referral form must be signed by the individual giving consent for the disclosure and transferral of personal information to Champions.
NOTE: A referral form is not required for individuals to access Champions’ services. Self-referral is welcome.