Phone: 613-969-7400 Ext. 2247



**Please read the following information carefully as we have recently made changes to our referral forms and eligibility criteria for some programs and services.**

The Quinte Children's Treatment Centre requires a medical referral from a physician or nurse practitioner for most services (please see the chart below for details).

The Quinte Children's Treatment Centre no longer requires a medical referral from a physician or nurse practitioner for some services where it was previously required.  Please see the chart below for details.

Referrals for in-Centre services may be made for children under the age of 5 who have developmental delays and/or communication challenges, as well as for any child from birth to school-leaving age with a physical disability (eg. cerebral palsy, muscular dystrophy or others). In order for services such as social work or psychometry to be considered, children and youth must require the services of in-Centre (core) physiotherapy or occupational therapy and referrals may only be made internally by these therapists, where appropriate.

Preschool children with speech and language concerns ONLY may be made by anyone but must have consent from all custodial parent(s)/guardian(s). Please note that referrals for our Preschool Speech and Language program are accepted up until June 30th of the child’s Junior Kindergarten year or age 5, whichever comes first.

The referral process for school-aged children for in-school physiotherapy, occupational therapy and speech therapy is different and must be made by the school the child attends.  There are specific documents that must be completed.  Please click here for additional information.

We require that the names and contact information for all custodial parent(s)/guardian(s) be included on the referral form.  In keeping with the Substitute Decision Maker hierarchy, both of a child’s parents are considered to have equal decision-making ability, unless there is a court order which indicates one parent has sole custody and decision-making ability.  Children/youth may act as their own decision-maker if it is determined that the child/youth understands the information that is relevant to deciding whether to consent and can appreciate the reasonably foreseeable consequences of giving, withholding or withdrawing the consent.

Options for submitting a referral:

  1. Referrals can now be uploaded electronically through our website using  Sync is an end-to-end, fully encrypted document transfer platform which is PHIPA-compliant, so you know that your personal health information is protected.  Please be sure to save your document before uploading as if a blank document is received, we have no way of knowing where it was sent from.  When you upload a document, the only confirmation you will receive is a check mark to the right of the document when the upload has been completed.  Please feel free to contact us to confirm that we have received your document.  To upload a referral or other document(s), please CLICK HERE.
  1. Faxing to: (613) 968-9154
  1. Mailing to:                
              Quinte Children’s Treatment Centre
              Quinte Healthcare Corporation
              Belleville General Site
              265 Dundas St. E.
              Belleville, ON  
              K8N 5A9

For referral information and questions, please call 613-969-7400 x 2264


Type of Referral


Physician/Nurse Practitioner Referral Required

Forms Required

Physiotherapy, Occupational Therapy, Feeding


Referral Request Form 


Preschool Speech and Language Program


Referral Request Form 


Autism Diagnostic Assessment (Primary Care Practitioners and Non-Paediatricians)


See DSM-5 Criteria for ASD here

Autism Diagnostic Hub Referral Package for Primary Care Practitioners and Non-Paediatricians

(includes Referral Request Form + ASD Hub Referral Form for Primary Care Practitioners and Non-Paediatricians) 

Autism Diagnostic Assessment - Paediatricians


Autism Diagnostic Hub Paediatrician Referral Package for Paediatricians

(includes Referral Request Form + ASD Hub Referral Form for Paediatricians)

Coordinated Service Planning No CSP Referral Form
FASD (Fetal Alcohol Spectrum Disorder) Support   No

FASD Referral Form

(*note this is not for FASD Diagnosis, support ONLY)