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Important Considerations Before Completing Our Intake Form

If this is an emergency, please call 911 or visit your nearest emergency department.

Catchment Areas

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. 

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Support Provided

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!

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Following Up With You

After receiving your submission, a member of the organization will contact you within 5 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.

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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. 

Important: Please remember to download, complete, and submit the Informed Consent Form above in order for us to schedule your initial appointment. We kindly ask that you take a moment to double-check and ensure the INFORMED CONSENT FORM is filled out accurately and completely before submitting this intake form. By doing so, you will help us minimize any potential delays in scheduling your appointment and provide you with the support you need. By providing all the required forms now, we aim to make the intake process faster and more efficient for you; ensuring quicker access to the support you need. If you have difficulty with any of these forms, please contact us. The Informed Consent Form can be conveniently completed online using software or websites such as Adobe or PDF Escape, on a computer, or alternatively, it can be printed, filled out by hand, and then scanned or photographed for uploading.

Important: Please remember to download, complete, and submit the Informed Consent Form here in order for us to schedule your initial appointment. We kindly ask that you take a moment to double-check and ensure the INFORMED CONSENT FORM is filled out accurately and completely before submitting this intake form. By doing so, you will help us minimize any potential delays in scheduling your appointment and provide you with the support you need. By providing all the required forms now, we aim to make the intake process faster and more efficient for you; ensuring quicker access to the support you need. If you have difficulty with any of these forms, please contact us. The Minor Informed Consent Form can be conveniently completed online using software or websites such as Adobe or PDF Escape, on a computer, or alternatively, it can be printed, filled out by hand, and then scanned or photographed for uploading.

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