Let’s Get Started! Fill out the form below and we will connect with you to discuss the next steps in getting you support. "*" indicates required fields Name* First Last Email* Phone*May we leave a voicemail at this number? Yes No I would like to be contacted by:(check all that apply) Phone Call Text Email (please check your junk folder) I have insurance and my provider is: Green Shield (SFC can bill directly) Another provider (you will pay SFC out of pocket and submit your receipt) I have insurance coverage for:(check all that apply) Registered Psychotherapist (RP) Registered Social Worker (RSW, MSW/RSW) Certified Canadian Counsellor I will check and let you know I do not have insurance coverage and will pay out of pocket Availability for Appointments(check all that apply) Monday 1:00 – 7:00pm Tuesday 1:00 – 7:00pm Wednesday 1:00 – 7:00pm Thursday 1:00 – 7:00pm Friday 1:00 – 7:00pm Saturday 9:00 to 3:00pm Sunday 9:00am to 3:00pm Mornings available upon request Please select who the counselling services are for: Child under age 6 (which is parent focused) Child between 7 to 10 years Tween between 11 to 13 years Teenager between 14 to 17 years Young adult between 18 to 25 years Expecting or New Parents Parent(s) only Other Please specifyPlease describe the primary concerns that have led you to seek counselling services?What changes would you like to see as a result of coming to counselling?Is there any other information you would like us to know?Is there a Family Counsellor with whom who prefer to work with? We ensure to match you with a Family Counsellor that is best suited for your needs, however we will take your preference into consideration. How did you hear about our services?CAPTCHA