Information for the health-care professional

To send a referral to the Alzheimer Society for education, support or information please print out the following form and fax the form back to the Alzheimer Society. 

Referral Form

For Education or Information, please refer to Kathy Gaudaur, Education Coordinator

For Support Services, please refer to Linda Brown, Support Counselor

Fax completed form to 705-495-0329