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Referral Form for Aboriginal Health Coordinator

Circle of Indigenous Nations Society
Main Office: 1801 Connors Road Castlegar BC V1N 3N9
Boundary Office: 7525 12th Street PO Box 1917 Grand Forks BC V0H 1H0

Aboriginal Health Coordinator Referral Form

Client information

Can we leave a message?
Do you have a Family Doctor or Nurse Practitioner?

Referral information

Other community agency involvement
Informed consent signed

West Kootenay Coordinator:

Phone: 250-608-4552 or 250-399-0731 ext. 103
Fax: 250-399-0731

Boundary Coordinator:

Phone: 250-444-9599
Fax: 250-352-0384