IDC/BCANDS Request For Services / Limits of Confidentiality and Release of Information Forms (Printable)

PRINTABLE REQUEST FOR DISABILITY SERVICES FORM

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

If you are unable to complete the online Request for Disability Case Management / Navigation services, please print the Request for Services PDF document below.

IDC/BCANDS Service Request / Limits of Confidentiality and Release of Information Forms

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Please complete all areas, including the Limits of confidentiality document, and fax it to: IDC/BCANDS DCM at (250) 381 – 7312

or mail to:

Attention: IDC/BCANDS DCM                                                                                              #6 – 1610 Island Highway – Victoria, British Columbia – V9B 1H8

Thank you.