Pediatric Application for FASD Clinic Services
The Northwest Central FASD Network coordinates community-based FASD assessment and diagnostic services and intervention planning for children and adults prenatally affected by alcohol exposure.
FASD assessment and diagnostic services are based on the Canadian Medical Guidelines established for diagnosing Fetal Alcohol Spectrum Disorders and are provided by a multi-disciplinary team of professionals specifically trained in the field of FASD assessment and diagnoses.
Click on links below to access application forms for FASD assessment and diagnostic services. Please note that there are forms to fill out for a child and there are separate forms for an adult.
Once completed, please forward this referral package digitally to the Northwest Central FASD Network
Pediatric FASD Application Package
For Pediatric referrals, please send to:
Sharon Pearcey,
780-284-3415,
sharonp@wwsn.ca
Adult Application for FASD Clinic Services
The Northwest Central FASD Network coordinates community-based FASD assessment and diagnostic services and intervention planning for children and adults prenatally affected by alcohol exposure.
FASD assessment and diagnostic services are based on the Canadian Medical Guidelines established for diagnosing Fetal Alcohol Spectrum Disorders and are provided by a multi-disciplinary team of professionals specifically trained in the field of FASD assessment and diagnoses.
Click on links below to access application forms for FASD assessment and diagnostic services. Please note that there are forms to fill out for a child and there are separate forms for an adult. The fillable referable form must be downloaded first before it can be filled out.
Once completed, please forward this referral package digitally to the Northwest Central FASD Network
Adult FASD Consents Package
Fillable Referral Form
For Adult referrals, please send to:
Jenn Pasic
780-974-7112,
jennp@wwsn.ca
Referral for Support Services
The Northwest Central FASD Network delivers community-based Outreach support services to individuals and families impacted with FASD and brain domain challenges similar to FASD. Services include: youth and adult mentorship programs, system navigation and community connection for caregivers of children mentorship program for women of child bearing years utilizing the Parent and Child Assistance Program (PCAP) mentorship mode. Click on the link below to access the referral form. Once completed, please forward this referral digitally to The Northwest Central FASD Network.
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