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Forms

Accessing Services at the I CAN Centre

Services for Adults

How do I get referred to the I CAN Centre?

  1. Download and print two referral forms, Adult Referral Part A and Adult Referral Part B.
  2. Part A is to be filled out by the patient or family; Part B is to be filled out by a health professional.
  3. In addition, select the secondary form that best address your needs.
  4. Send them in together to the address listed at the bottom of Part A to begin the referral process.

Secondary Forms

Services for Children

How do I get my child referred to the I CAN Centre?

  1. Download the main referral form, Child Request for Service Form. 
  2. Complete the main referral form, then select the secondary forms that best address your needs. 
  3. Send them in to begin the referral process.

Secondary Forms

Forms can be mailed or faxed to:

I CAN Centre for Assistive Technology
10230-111 Avenue,
Edmonton, Alberta
T5G 0B7

Fax: (780) 735-6072

Information 

These fact sheets will help you learn more about the I CAN Centre and how we provide services: