Individuals, Parents, Guardians
Physicians, Healthcare Providers, Community Agencies
School Staff
For school-based services
Note: You do not need a doctor’s referral to request most JMCC services. We accept requests from families, caregivers, healthcare providers, and community agencies.
After You Submit a Request
Once we receive your form, a member of our intake team will review the information and contact you to discuss next steps. This may include confirming eligibility, requesting additional documentation, or setting up an initial appointment.
Need Help or Have Questions?
Contact us at 519-252-7281 or 1-800-976-5622 or email [email protected]. We can be reached Monday – Friday, 8am-5pm.