APPLY FOR SERVICES PDF FORM

Eligibility Criteria

We may be able to help you if you meet the following eligibility criteria.
To be eligible for general services, the individual must:

• Have a primary diagnosis of an Acquired Brain Injury (ABI)*
• Be 16 years of age and over
• Reside in the region of Peel, Halton, or Dufferin County (may waive this criterion should an individual be able to travel to Mind Forward locations)
• Be an active participant in achieving mutually agreed-upon goals
• Be medically stable
• Be free of psychiatric or behavioural symptoms of an order that would preclude the individual from being able to participate in mutually agreed-upon goals

* The agency has adopted the World Health Organization’s definition of ABI: “Damage to the brain, which occurs after birth and is not related to a congenital or a degenerative disease. These impairments may be temporary or permanent and cause partial or functional disability or psychosocial maladjustment” (Geneva 1996)

MUST include all relevant brain injury medical and consult reports – i.e. Neuro-imaging (MRI, CT scan), Neurology report, Emergency Room Reports and/or Hospital Admission/ Discharge Notes.

Processing of the referral will be significantly delayed if the above is not included.

Please return completed applications and relevant assessments and reports to: