P.A.C.E. Inc.
Therapy, Counselling, Case Management and Consulting
Proudly serving Chatham-Kent, Sarnia-Lambton and surrounding Areas
519-355-9576
Please reference these forms as requested by our intake workers.
Children and youth under the age of 16 require parent/guardian permission to receive services from P.A.C.E. Inc. By filling out and submitting this form, you agree to, and allow PACE Inc. to assess your child's needs, and provide necessary supports to meet identified needs (e.g., intervention, counselling, tutoring, respite, referrals, etc.).
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To complete the CHILD CONSENT FORM click here.
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As an adult, you must consent to receive services offered by P.A.C.E. Inc. By filling out and submitting this form, you agree to, and allow PACE Inc. to assess your needs, and provide necessary supports to meet identified needs (e.g., intervention, counselling, tutoring, referrals, etc.).
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To complete the ADULT CONSENT FORM click here.
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I understand that communicating and exchanging information with other Services/Professionals may be necessary for the well-being and success of myself/my child.
By completing this form, I give permission to P.A.C.E. Inc. to obtain information from and/or provide information to the following agency and/or person provided.
*Please complete this form for each individual person/agency that is involved.
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To complete the CHILD R.O.I WAIVER click here.
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To complete the ADULT R.O.I WAIVER click here.