BCANDS On-Line Client Service Request Form

* For the text to voice option, on any page of the BCANDS website, simply highlight the text you wish to hear and click on the speaker icon!

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BCANDS is pleased to offer this on-line service request form for your convenience.


 * Please Note: Once you have completed the form and pressed the “submit” button, the webpage will automatically default to the top. Once this occurs, please scroll down the page to ensure that there were no error messages or missing information required for submission. In the event that there is information still required, simply fill in the required field(s) and when completed press submit again, and then scrolling down once again to ensure submission.

In order to assist you and provide the services you require to meet your needs it is necessary for us to collect personal information. We would like to assure you that the information we collect, use and may disclose, with your consent, is protected under the Personal Information Protection Act. If you any questions or concerns about the collection, use or disclosure of your personal information please mention this the BCANDS case worker or you can contact the ‘Office Of The Information & Privacy Commissioner’.
  • and middle name
  • (Located on bottom of card)
  • (Located on bottom of card)
  • Please provide a brief description of the nature of your disability.
  • Please provide a brief description on how BCANDS can assist you.

Thank you!