Official Bell Homestead NHS Website, City of Brantford

Tell A Friend 

Tell A Friend Form

By completing the following steps, you will send your recipient a link to this website.

Step 1. Who Would You Refer This Site To?

Please type your information into each of the fields in this section to move to step 2. Name, Email ID are required.

Step 2. Enter Your Contact Information

Please type your information into each of the fields in this section to move to step 2. Name, Email ID are required.

Step 3. Send A Custom Message

Please type your message to your recipient. Maximum 500 Characters. # $ % ^ & * ( ) are not allowed. Message is required.


Step 3. Enter Code (required)
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When you are finished, click on the 'Submit' button. If you would like to start over, select the 'Clear Form' button to clear all fields in the form.