Request Service
Potential Clients and
Referring Doctors
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.
If you are
a family Doctor or Eye Care Specialist, you 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. Section
C - Eye Information to be completed by a Doctor must be completed by a family
Doctor or Eye Care Specialist as it assists the CNIB in determining how we can
better assist you.
Request for Service Form
Return the form by
fax to:
CNIB Client Services
Attention: Yolanda Malabanan
1929 Bayview Ave
Toronto, ON M4G 3E8
Fax: (416) 480-7700
Depending on the number of requests in your area, it will
take at least two to three business days for someone to contact you.
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