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* 1. How did you find out about OPACC?

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* 2. Please enter your contact information below

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* 3. Are you...?

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* 4. Please tell us a little bit about your child

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* 5. Treatment centre

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* 6. Satellite centre (if applicable)

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* 7. If you are a support group member, please specify which one

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* 8. OPACC is an independent registered charity; while we often partner with other organizations to provide services to our families, our programs are managed separately. OPACC receives no government funding and all funding for the development of our programs, services and special events comes from the donations of generous organizations, businesses, foundations, and individuals. We rely on the support of our members to ensure the ongoing development of our organization. If you are in a position to help, please indicate your interest(s) below and we will be in touch with more information on how you can support our work. Thank you!

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* 9. Other

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