Critical Incident Stress Debriefing (CISD)
Our Critical Incident Stress Debriefing program provides timely, compassionate support to help employees cope with traumatic workplace events. This structured intervention strengthens emotional resilience and supports mental well-being when it matters most.
Main Contact Details
Date of referral
*
-
Month
-
Day
Year
Date
Union/Organization/Municipality
*
Main contact initiating referral
*
First Name
Last Name
Job Position
*
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Secondary Contact?
Yes
No
Secondary Contact Initiating Referral
First Name
Last Name
Job Position
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
CISD Details
1. Location needing support
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
2. Date of incident
*
-
Month
-
Day
Year
Date
3. Brief description of reason for seeking support
4. Requested date of CISD
-
Month
-
Day
Year
Date
5. On-site or Virtual?
*
On-Site
Virtual
6. Requested clinical management consult time
*
Note: The main contact number provided will be the number called.
7. Additional details you would like to provide to the clinical management team
*All CISD requests will be responded to within 24 business hours.*
Submit
Should be Empty: