Connection Form
Please fill out the following form and you'll receive an email response with the name and address of the person who will be reaching out directly to you!
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Age Category
*
8-9
10-11
12-15
16-18
18+ (Adult)
What Services Are You Seeking
*
Counselling (Mental Health & Trauma)
Energy Healing
Trauma-Coaching
Connection Option Preference:
*
Virtual Counselling
In-Person Counselling
Combination of Both
No Preference
What Days of the Week Work Best for You?
What Time of Day Works Best for Your Schedule? (Morning, Afternoon, Evening)
Is there someone you specifically would like to connect with?
No Preference
Anjali Nagda (Clinical Counsellor)
Blake Miller (Social Worker)
Emma Stenton (Starting Soon)
Isabella Weiss (Starting Soon)
Kyle Loney (Clinical Counsellor)
Lea Morrison (Energy Healing)
Paige Mathison (Clinical Counsellor)
Michelle Tucsok (Social Worker)
Samantha Hellwig (Clinical Counsellor)
Please provide a brief description of what you'd like support with and any questions you may have!
*
Submit
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