Please provide first and last name
Please provide an email address for email confirmation.
Parent One - Primary Contact information will be used
Please indicate, as this impacts which counsellor you will be assigned to.
Please note: We must have copies of the child custody arrangements before we can see your child.
(select all that apply)
This question refers to the ethnic or cultural origins of a person’s ancestry, who we identify as, or what environment we are from.
This question refers to how your child has been raised, based on the moral/social principles we use to govern our lives, and how we view the world.