Request for Service

CNIB Services are available to people who have difficulty with everyday activities due to vision loss.

Potential Clients

If you would like to request CNIB service in your area, please complete Section A of the Request for Service form below and submit it to CNIB. This form is available in an accessible MS Word format, in regular MS Word format or in PDF format. Depending on the number of requests in your area, it will take at least two to three business days for someone to contact you.

You may also register by telephone by contacting Lisa Totarella at 1-800-465-4622 ext. 221.

Referring Doctors

Family Doctors and Eye Care Specialists can play a key role in referring patients for low vision rehabilitation services. If your patient would benefit from CNIB services, please complete the Request for Service form below.

Return the form by fax to:

CNIB Client Services
Attention: Lisa Totarella
3044 Delisle
Montreal, Qc, H4C 1M9

Fax: (514) 934-2131

More Information

Call us at 1-800-465-4622. This line is open Monday to Friday, 8:30 a.m. to 4:30 p.m. EST, and a voice mail option is available at other times.