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INTAKE FORM

Please carefully review and consider the following prior to completing and submitting our intake form. If this is an emergency, please call 911 or visit your nearest emergency department.

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For the best experience, we recommend completing this form on a computer or laptop, as it is easier to navigate. However, it can still be completed on a mobile device if needed. If you experience any issues, please contact us.

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If completing this form is not accessible to you, please call us or email us, and we will be happy to assist you by completing the intake over the phone.

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 offer peer-based support rather than counselling, therapy, or crisis intervention. Our services are grounded in shared experience, compassionate listening, and community connection. If you’d like to learn more about how peer support differs from clinical support, or if you're unsure whether peer support is the right fit for you, please visit our FAQ page or complete our quick self-assessment by clicking here. If you are seeking counselling or therapy, you can explore options through PsychologyToday. For immediate emotional or crisis support, please click here for resources.

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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 (December 19 - January 2, 2025).

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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. 

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Referral Information for Professionals

If you are looking to refer a client to our services, or if you would like your client to access our support, please review our Referral Pathway (CLICK HERE) before proceeding. This document provides essential details about our services, referral criteria, and intake process. We require client consent before accepting any referral or intake form completed on their behalf. Please ensure your client has agreed to participate in our services prior to submission.

We appreciate your feedback on your intake experience, whether you choose to provide it anonymously or with your name. You can share your thoughts by clicking here. 

We appreciate your feedback on your intake experience, whether you choose to provide it anonymously or with your name. You can share your thoughts by by clicking here. 

ABOUT US

The Centre for Grief and Healing

(also known as Bereaved Families of Ontario - Halton/Peel) is a local, registered charitable organization offering compassion and care for individuals dealing with the death of a loved one.  

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CONTACT

T: 905-848-4337

 

A: 610-33 City Centre Drive

Mississauga, ON L5B 2N5

 

E: info@bereavedfamilies.ca​​​​​​​​​​

DONATE TODAY

The Centre for Grief and Healing (also known as Bereaved Families of Ontario - Halton/Peel) is a local, registered charitable organization that relies on donations to sustain our programs. Make a donation today!

Registered Charity #118803667RR0001

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LAND ACKNOWLEDGEMENT

We want to acknowledge the land on which we gather, and where the Centre for Grief and Healing (BFO-H/P) operates. This land has been and is still inhabited by many Indigenous Peoples since the last Ice Age which was 13,000 years ago. In particular, we acknowledge the territory of the Anishinabek-Ojibway/Chippewa, Huron-Wendat, and Haudenosaunee peoples. The land that is home to the First Nations, Metis, and Inuit people. We are grateful to now be on the land that is the land of Indigenous Peoples since time began.

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The land we are presently on is under the stewardship of the Mississaugas of the Credit, who are the signatories of the treaty and holders of the area. We recognize that the land we are on was taken away through colonization, oppression, and expropriation. In the hopes for a better future and building relationships, we recognize, require, and honour what is in the truth and reconciliation report and the calls to action. We acknowledge and are grateful for having the privilege of being where we are, for this land, and for the Indigenous Peoples who have and continue to inhabit this land.

 

This Land Acknowledgment was created in collaboration with Indigenous Elder, Cat Criger. 

© 2025 All Rights Reserved. Created by the Centre For Grief & Healing (Bereaved Families of Ontario - Halton / Peel)​

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