Mi'kmaq Family Support Referral

Mi'kmaq Family Support aims to provide child-centered support to families, helping to navigate systems and coordinate services. The Jordan’s Principle’s federal Service Access Resolution Fund (SARF) is available to access if a First Nation child requires a health, social or educational service/item/product that is publicly-funded and available to most other children, but for some reasons, the First Nation child is unable to access it in a timely manner of the service itself or the provider is not appropriate/sufficient to meet the child’s/family’s needs. 

 

To download a blank referral form: click here to download. 
Completed forms can be sent to:
Mi’kmaq Family Support Confidential Fax  506-627-8227

Alternatively you can complete a Referral Form online:

Mi’kmaq Family Support Referral Form

Date *
Date
Name of Child Being Referred: *
Name of Child Being Referred:
Birthdate *
Birthdate
Birthdate of Child Being Referred
Parent/Guardian Name: *
Parent/Guardian Name:
Phone Number *
Phone Number
Address *
Address
Alternate Contact Person
Alternate Contact Person
Alternate Contact Person Phone Number
Alternate Contact Person Phone Number
If applicable, Name of Person Referring:
If applicable, Name of Person Referring:
(if applicable)
Agency Contact Number
Agency Contact Number
(if applicable)
 

 

To download a blank form: click here to download.