UPDATE YOUR SERVICE PROFILE


Describe your organization or service using the form below, and then click "Submit Service" when completed.

Your submission will not be displayed online until it has been reviewed and standardized by administrative staff.


Service Name:
Level 1:   
Level 2:   
Level 3:   
Level 4:   
Level 5:   
Former Name:   
Phone Numbers: Office:   
Toll-Free:   
TTY:   
Crisis:   
After Hours:   
Fax:   
Email:   
Website:   


Mailing Information: c/o:   
     Street Address: (if different)
Building:   
Address:   
City:   
Province:   
Postal Code:   
Room:
Intersection:
Accessibility:
Accessibility Notes:
Hours:
Dates Available:


Executive: Name:   
Title:   
Organization:   
Phone:   
Email:   
Executive 2: Name:   
Title:   
Organization:   
Phone:   
Email:   


Public Contact: Name:   
Title:   
Organization:   
Phone:   
Email:   
Public Contact 2: Name:   
Title:   
Organization:   
Phone:   
Email:   
Provider Contact: Name:   
(if different) Title:   
Organization:   
Phone:   
Email:   
Description:
Meetings:
Provider Notes:




LHIN Funded:
Funding:
Fees:
Application:
Application Notes:
Target Population/Eligibility:
Age:
Minimum:    Maximum:  
Languages:



French
Language Note:
Area(s) Served:
Year Established:
Legal Status:


YouTube Video #1 URL:   
Title:   
YouTube Video #2 URL:   
Title:   
YouTube Video #3 URL:   
Title:   


Please ensure that you include your name, email address and telephone number in case we need to contact you to confirm your changes.
Source: Name:  
Title:  
Organization:  
Phone:  
Email:  
Comments:


Types of Changes Submitted:
       
 



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