The Blind Low Vision Program is available for children with low vision or blindness from birth to school entry. Services can take place virtually, in the child's home, childcare, and community settings.We provide support to the family and child with low vision/blindness, including direct intervention; consultation to your child's healthcare team and daycare; and support with school transition.A referral to our program can be made by anyone in your child's life (e.g. ophthalmologist, daycare provider, allied health professional, parent/legal guardian, etc.) The child must be living in Eastern Ontario (Ottawa; Renfrew County; Prescott-Russell; or Stormont, Dundas and Glengarry.)
First name*
Middle Name/Initial
Family/Last Name*
Day
Month
Year
Warning: Submission may be denied.
Child Health Card Number*
Family Doctor Name
Email* (Confirmation and reminder emails will be sent here)
Primary Phone*
Secondary Phone
Unit/Suite #
Street # & Street Name*
City*
Postal/Zip Code*
What is the preferred Language?
Is an interpreter required?
Primary Diagnosis
Please share your concerns about your child’s vision
‘Please attach any relevant medical documents. For example, ophthalmologist report, Infant and Child Development report, etc.
Are you sending any additional documentation separately by a method other than online through Caredove (e.g, via fax)?
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