Talk 2 NICE Referral Form
Talk 2 NICE, is a free friendly check-in service specializing in the care of elders and disabled community members.

All people are welcome to reach out for support.

Our goals are to offer free ongoing, over the phone, friendly outreach and brief counselling services to socially isolated and lonely community members through brief friendly check in calls.

We strive to respond to all referrals between 24 and 48 hours.

Please note, this is not a crisis service. If this is an emergency please contact 911.

If you require crisis support please contact, Toronto Distress Centres: 416 408-4357 or 408-HELP.
Email address *
Name of Person Completing this Form *
Name of Person Being Referred *
Their primary phone number *
Their email (if available)
Their City and Province
Does this person have access to any or all of the following *
Required
Does this person have access to internet *
Emergency Contact (Name)
Emergency Contact (Phone Number)
Emergency Contact Relationship to Client
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