I understand that I will be contacted by someone from Starbright Children’s Development Centre by email, and/or phone.
I understand that Starbright’s services are provided at our Centre, at home or via tele-health, based on your child or family
I understand that if Starbright’s sessions are being conducted by tele-health, this includes treatment using interactive audio,
video, or data communications, and that:
Please check off the following:
I understand that when this request for service is received, I will be contacted by someone at Starbright Children’s Development Centre.
If you choose the email option, please remember the following:
For our clients and their families: Please know that there is always a risk that email may be intercepted between the sender and the receiver. Starbright Children’s Development Centre does not use email for confidential information unless that mode of communication is specifically requested by the client/family. Email is not secure, nor is it confidential. If you continue to use email communication, it means that you accept this risk. If you feel that email communication is insufficiently secure for the confidential information you wish to communicate, please call our office by telephone.
To prevent duplication of services, we work in partnership with the Speech and Language Department at Interior Health and the
Family Connection centre (FCC). We review all new referrals on a regular basis and divide them between the three agencies so
that your child receives the best service available.
Please complete information below for all providers for which you give consent.
To provide safe and effective services for your child, Starbright staff may need to request information from, and share information with, your child’s other service providers. The records for your child may also be accessed by Centre staff and reviewed for purposes of accreditation. All information is treated as strictly confidential. A copy of this consent will be sent to all persons/agencies when information is requested from them. Starbright reports will be sent to the parent(s) and/or guardian(s).