We are pleased that you’ve chosen to embark on this journey with us to support the well-being of your child or youth. Completing this intake form is the first step toward ensuring that we provide a personalized and compassionate experience tailored to their unique needs.
At Your Counselling, we understand that each child is different, and their mental health and emotional well-being are important to their growth. The information you provide will help us gain a deeper understanding of your child’s situation and how we can best support them through their challenges. Rest assured, everything shared is kept confidential, and we encourage you to take your time with the form.
If you have any questions or need assistance during the process, please don’t hesitate to reach out to us. We’re here to support both you and your child every step of the way.
Please note the following:
- The Legal Guardian of the child / youth is to complete this package
- All contact information should be in reference to the Legal Guardian
- There are two places where a signature is required, which you can do easily from any mobile device, tablet or computer.
- Fields do not save as you go and the form must be completed in one sitting. It will take about 5-10 mins to complete
- Click Submit when done.
If you have any issues or questions about this form please contact our office.