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Showing a young child playing in his Pacekids classroom

Pacekids Programs ECS Inquiry Form

Child's Full Name

Child's Date of Birth

Child's Gender

Male Female Unspecified

Is your child a Canadian Citizen?

Yes No

Languages most frequently spoken at home:

Will your child require transportation?

Yes No Undecided

Home Address

Postal Code

Community Name

Phone Number

Email

Parent/Guardian Name

Area of Concern:

Speech Language Pathology Occupational Therapy Physiotherapy Behavioural Strategy Other

If you selected "Other" to Area of Concern:

Diagnosis:

Suspected Confirmed

What is your child's suspected or confirmed diagnosis?

Has your child accessed PUF (Program Unit Funding) before?

Yes No Unsure

If your child has accessed PUF before, where did they attend?

Family Support for Children with Disabilities (FSCD) Application Status

Would you like to be connected with our In-Home Intake Coordinator to discuss FSCD programming options?

How did you hear about Pacekids?

If "Other," please tell us how:

Subscribe me to the ECS e-newsletter for the latest updates and resources.

Please read and confirm to complete your form

Thank you for your interest in Pacekids ECS Programs. Our ECS Coordinators will respond as soon as possible. If this is urgent, please call 403-234-7876.

Pacekids empowers children with diverse needs and their families through excellence in therapy, education, and play.

#89131 3363 RR0001

Contact and Location

Pacekids Sunridge:
#130 2850 Sunridge Blvd NE, Calgary, AB T1Y 6G2

Pacekids Sundance:
#130 23 Sunpark Drive SE, Calgary, AB T2X 3V1

Phone: 403.234.7876

Email: [email protected]

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Thank you for your submission!

Thank you for submitting an ECS inquiry! Our ECS Intake Team will be in touch as soon as possible to answer any questions you may have.

In the meantime, please review the ECS Program Overview below.

Read more about our ECS Program