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Intake Form

PLEASE READ BEFORE COMPLETING INTAKE FORM:

  • Please fill out our intake form if you are interested in pursuing services through Children's Therapy Collective. 

  • Once we receive your form, we will be in contact within three business days with next steps. We may require further information or to plan a free phone meeting to discuss further. Counselling clients will be asked to book a free intake meeting. 

  • Physiotherapy clients and massage therapy clients are able to book directly without needing to complete the intake form.

  • Please note that some of our services have waitlists.

About

Which services are you interested in:
Are you looking for in-home, in-office, or virtual supports? Check all that you are potentially interested in.
We support children that are funded through different agencies, including Jordan's Principle and Variety. Are you pursuing funding through an agency and therefore would require a quote?
Yes
No
Not sure
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