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Healthy Babies Healthy Children program referral form

Healthy Babies Healthy Children (HBHC) is a free, voluntary program for expectant parents and families with children from birth up to transition to school.

Who can refer?

HBHC referrals can be made as a self-referral or a professional referral from a healthcare or service provider.

Eligibility:

  • expecting a baby; or
  • parenting a child from birth up to transition to school age; and 
  • living in Huron or Perth county (area served by Huron Perth Public Health)

 

Referral source
 

Client information

Preferred method of contact (public health nurse will contact you/client after receiving referral):
 
Referral type
 
Other services you/client are involved with:
 
How did you/client find out about the home visiting program?
 
By checking this box, I acknowledge that the information provided in this form is correct. I understand that I/client will be contacted by a Public Health Nurse.
 

Personal or personal health information on this form is collected under the authority of the Health Protection and Promotion Act and applicable privacy legislation. This information will be used for the delivery of public health programs and services and may be used for evaluation or statistical purposes. Any questions about the collection of this information should be directed to the Privacy Officer, Huron Perth Public Health, 1-888-221-2133 or email privacy@hpph.ca. 



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