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What is the Healthy Babies Healthy Children (HBHC) Program?

- A province-wide program that offers support to pregnant women & families with children from 0 - transition to school.
- Free, confidential and voluntary.
- Provides support and information on topics such as pregnancy, breastfeeding, healthy eating, baby care, growth and development, discipline, as well as many other issues.
- A parent can become involved in this program at any time from pregnancy until the child starts school.
- Is this program right for you? Learn more here.
The Personal Health Information on this Healthy Babies Health Children (HBHC) Online Referral Form is collected under the authority of the Health Protection and Promotion Act applicable privacy legislation. All information collected will be stored in a confidential and secure electronic database. This information will be used for delivery of public health programs and services and to assess the need for prenatal, postpartum, or early childhood support and may be used for evaluation or statistical/research purposes. Any questions about the collection of this information should be directed to our Privacy Officer, Southwestern Public Health, 1230 Talbot Street, St. Thomas, ON N5P 1G9 or via Phone: 1-800-922-0096.

Datefield type date
Date will be captured on form submission
Referral to SWPH's HBHC Program*field type radio button
Referral to SWPH's HBHC ProgramSelf-ReferralAgency Referral
How did you hear about our services?*field type drop-down
Other:field type single line
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Referring Agency*field type single line
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Name of Referring Agent*field type single line
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Business Phone*field type single line
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Business Email*field type email
Is the family aware of this referral?*field type radio button
Is the family aware of this referral?YesNo
Return Report Requested by Agency*field type radio button
Return Report Requested by AgencyYesNo

Client Surname*field type single line
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Client Name*field type single line
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Client's Date of Birth*field type date
Client Address*field type address
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Country
What county do you or the client live in?*field type radio button
What county do you or the client live in?ElginOxford
Client Phone Number*field type single line
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Client Emailfield type email

	Full Namefield type single line	Date of Birthfield type date	Relationshipfield type single line	Commentsfield type single line
Row 1×	Full Namefield type single line Input blocked. Maximum character limit of 4000 characters reached.	Date of Birthfield type date	Relationshipfield type single line Input blocked. Maximum character limit of 4000 characters reached.	Commentsfield type single line Input blocked. Maximum character limit of 4000 characters reached.	×

Reason for Referral*field type multi line
Safety Issues*field type radio button
Safety IssuesYesNo
Do you have documentation to send to us?*field type radio button
Do you have documentation to send to us?YesNo

Please either upload all relevant documentation below, or fax all relevant documents to 519-633-0468 (St. Thomas & Elgin County) or 519-539-5059 (Oxford County).
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This HBHC service is provided for residents of St. Thomas, Elgin County, and Oxford County. If you do not reside in these areas, your information will be forwarded to the appropriate health unit. If you have questions or concerns, you can reach us at 519-631-9900 ext. 1400 (St. Thomas & Elgin County), 519-421-9901 ext. 3473 (Oxford County), or Toll Free at 1-800-922-0096. Our business hours are Monday to Friday, 8:30 a.m to 4:30 p.m.