Training & Education

Application for FASD Clinic Services

The Northwest Central Alberta 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 the links below to access an application package for FASD assessment and diagnostic services.  Please note that there are two separate consent forms for children and adult referrals, and that the legal guardian must sign the consent forms for the child in order to proceed with the referral.
Once completed, please forward the application package to the Northwest Central Alberta FASD Network office by fax (780-470-2048) or by mail:


Training & Education Contacts:
ATTN: Donna Kristiansen Ph: 780.305.8757 | Angela Kemble Ph: 780.305.8827
NWC Alberta FASD Network
Box 5389
Westlock, Alberta
T7P 2P5


Please contact Sharon Pearcey or Jennifer Pasic’s should you have any questions about the referral or the clinic process



Sharon Pearcey:

phone at780-284-3415



Jennifer Pasic’s:

phone at780-284-7112