UPDATE YOUR SERVICE PROFILE



Enter the following about your organization and/or service. When you are finished, click "Submit Service".

Your service will not appear immediately on the site. southwesthealthline.ca staff will review the information submitted.

Information displayed in the coloured cells below are not mandatory to enter.

Notes
Orange - Information entered in the orange fields does not appear on the public site. It is used by health care professionals for planning and/or data management purposes.
Green  - Information entered in the green fields also does not appear on the public site. It is displayed to health care providers for information and referral purposes to assist clients.





Organization: Level 1:     
Level 2:   
Level 3:   
Level 4:   
Level 5:   
Former Name:   
Phone Numbers: Office:   
Toll-Free:   
TTY:   
Crisis:   
After Hours:   
Fax:   
Email:   
Website:   



Mailing Information: co:         Address: (if different)
Building:   
Address:   
City:   
Province:   
Postal Code:   
Room:
Intersection:
Accessibility:
Accessibility Notes:
Hours:
Dates:



Executive: Name:   
Title:   
Organization:   
Phone:   
Email:   
Executive: Name:   
Title:   
Organization:   
Phone:   
Email:   



Contact: Name:   
Title:   
Organization:   
Phone:   
Email:   
Contact 2: Name:   
Title:   
Organization:   
Phone:   
Email:   
Provider Contact: Name:   
(if different) Title:   
Organization:   
Phone:   
Email:   
Description:
Meetings:
Notes For Providers:



More About:
(max. 250 characters)



Video #1 URL:   
Title:   
Video #2 URL:   
Title:   
Video #3 URL:   
Title:   
NOTE: Videos must be posted to YouTube. Insert the YouTube URLs of your video above. Videos should be no longer than 15 minutes in length.



LHIN Funded:
Funding:   
Fees:
Application:
Application Notes:
Eligibility/Pops. Served:
Age: Minimum:   
Maximum:   
Languages:
French












Language Note:
Area(s) Served:
Established:
Legal Status:



Source: Please ensure that you include your name, email address and telephone number in case we need to contact you to confirm your changes.
Name:
Title:
Phone:
Email:
Organization:

Email PDF documents to be included with the profile to editor@thehealthline.ca . Please keep the file size below 500kb
Comments:



Types of Changes Submitted: