Important Considerations Before Completing Our Intake Form
If this is an emergency, please call 911 or visit your nearest emergency department.
Our catchment areas are Ontario, specifically Halton/Peel regions. Please visit our FAQ page for more information if you do not reside in Halton/Peel prior to completing this form.
We do not provide counselling, therapy, or crisis support. All services provided are based on peer support. Visit our FAQ page to learn the difference between peer support and clinical support. Please refer to PsychologyToday should you like to receive counselling or therapy or click here for crisis/immediate support resources. Wondering if peer support is the right fit for you? CLICK HERE to complete a quick self-assessment!
Following Up With You
After receiving your submission, a member of the organization will contact you within 10 business days (with exception of statutory holidays and office closures) to schedule your initial session with a staff member, a volunteer, or a student. Please ensure you check your Junk and Spam folders as our initial email is often sent there first. Note we are not open during the last two weeks of December for our annual closure.
Children, Youth, and Minors
If you are completing an intake for someone under the age of 16, please scroll down to complete our Minor Grief Support Intake Form.