Please complete this intake form prior to your first appointment. This allows your counsellor to understand your concerns and obtain essential information about your background. It is considered to be confidential information between you and your counsellor and will not be used for any other purposes. We will not contact any person listed without your prior written consent. Please read the Confidentiality and Professional Care form located here before starting this intake form. Questions marked with an asterisk (*) require a response.
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Confidentiality and Professional Care