If you are interested in the services provided by Seniors Life Enhancement Centres please complete the enquiry form linked below. You will be contacted upon receipt of the Enquiry Form.
The programs offered by Seniors Life Enhancement Centres are designed for Mississauga residents who have physical impairments independently or who have Alzheimer’s disease or other cognitive impairments that interfere with their capacity to function. The program offers stimulating, therapeutic, social and recreational activities that enhance the quality of life of our clients, while providing respite and support to caregivers.
Which Program are you applying to be referred to? This enquiry is for Circle of Friends (adult day service for clients with Alzheimer's disease, dementia and/or other cognitive impairments). This enquiry is for Gathering Place (adult day service for clients with any of the following: physical disabilities, mild cognitive impairments, frail health). Not sure
Name of person enquiring
Organization you are affiliated with – if applicable
Your Phone Number
Your Email Address
Your Relationship To Client
Potential Client's Name
Name of Primary Caregiver
Primary Caregiver Phone Number
Primary Caregiver Email
Primary Caregiver Relationship To Client
Please indicate the diagnosis of the client and/or current functioning level.
Are you currently receiving services coordinated by the Community Care Access Centre (CCAC)? No Yes
Name of Case Manager:
Please enter visible characters
Thank you for submitting your application. Someone from our team will contact you after we have reviewed it.
