If you would like to receive counselling services, please fill out an intake form.

Before you begin

Please read through the What to Expect section and our Privacy Policy before completing the intake online.  This is where we provide important information about our program and the services we provide, as well as how we maintain your privacy and confidentiality. 

How it works

  • Click on the links below to fill out the intake form that matches the type of counselling services you want. 
  • The link will take you to our online intake form, where you will fill it out and submit it.*  This will take about 10 minutes to complete.
  • You will then receive an email confirmation from the Intake Worker as soon as possible (please note that the intake worker is not in the office every day).

*You will need an email address to complete the intake form online.  If you do not have one, please call the intake worker to complete an intake over the phone. 

Online Intake Forms

Individual Adult Counselling

Intake Form

click here

Child/Youth Individual Counselling

Intake Form (18 years of age and younger)

click here

Couples Counselling

Intake Form

click here

Family Counselling

Intake Form

click here

Downloadable Forms


Please note that we require both parents and/or legal guardians to sign the informed consent for counselling services provided to individuals 18 years and younger.  If a parent or guardian has full custody, one signature will suffice.  Please contact the intake worker if you have questions.

What happens to my intake form?

  • Once you submit your intake, you will receive an email confirmation. 
  • Within a few days, the intake worker will notify you of the waitlist and provide details regarding the next steps.
  • Your intake form will then be placed on the waitlist.
  • When your intake reaches the top of the waitlist, a counsellor will be given your form.
  • Your intake form is securely stored with the intake worker until your counselling commences.  If you have questions, please contact the intake worker.

 **It is advisable to submit your online intake in a private, secure place.  Using a Public Wi-Fi Network does not protect your privacy and confidentiality.  Choose to do so at your own risk. **