Skip to content

Healthy Babies Healthy Children Referral Form for Service Providers

Entry stage
Name of parent or caregiver(Required)
Address(Required)
Prenatal due date (if applicable)
Name of youngest child (if applicable)
Youngest child's date of birth
Name of other child (if applicable)
Other child's date of birth
Reason(s) for referral(Required)
Client consents to being contacted by a Public Health Nurse(Required)
Only clients that provide their consent will be contacted by a public health nurse
Referred by(Required)
This field is for validation purposes and should be left unchanged.

What's Happening Soon

View Our Calendar

Pembroke Office

141 Lake Street, Pembroke, Ontario K8A 5L8

Phone: 613-732-3629
Toll Free: 1-800-267-1097
Fax: 613-735-3067

Hours of Operation
Monday to Friday, 8 a.m. - 4 p.m.

Renfrew Service Hub (By Appointment Only)

120 Plaunt Street South, Renfrew, Ontario, K7V 1M5

Services offered by appointment only.

If you require an alternative accessible format or assistance accessing information on this page, please contact us at contact@rcdhu.com or 613-732-3629.