Request for Service
CNIB Services are available to people who have difficulty with everyday activities due to vision loss.
If you would like to request CNIB service in your area, please complete Section A of the Request for Service form below and submit it to CNIB. This form is available in an accessible MS Word format, in regular MS Word format or in PDF format. Depending on the number of requests in your area, it will take at least two to three business days for someone to contact you.
Family Doctors and Eye Care Specialists can play a key role in referring patients for low vision rehabilitation services. If your patient would benefit from CNIB services, please complete the Request for Service form below.
Return the form by fax to:
CNIB Client Services
Attention: Yolanda Malabanan
1929 Bayview Ave
Toronto, ON M4G 3E8
Fax: (416) 480-7700
Call our dedicated Client Services team toll-free at 1-800-563-2642. This line is open Monday to Friday, 7:30 a.m. to 7:30 p.m. EST, and a voice mail option is available at other times.