Therapeutic Service Intake Form
If you are having a mental health emergency, please contact the 24 Hour Mental Health Crisis Line at (441) 239-1111.
Before completing this form, please review our WRC Service Policy.
To access any of the following services, this intake form must be completed:
Individual Counselling
Restorative Mediation
Co-parenting Mediation
Fee: $100 per session
Need support? Sponsorship is available for those facing financial hardship.
Please complete the Sponsored Services Application to apply.