Counselling Intake Form
CLIENT INFORMATION
This intake form must be completed before your first counselling appointment.
This information will help our counsellor prepare for your session.
*Note: Fee for counselling service is $100 per session. However, sponsorship is available for those in financial need. Please complete the Sponsored Services Application to apply for sponsorship.
Donations towards your service are not required, but greatly appreciated to ensure we can continue to provide this essential service to women in the community.