Becoming an new client

Prospective clients can download our intake form. Please print it and fill in the required information to the best of your ability. Not filling out the form in its entirety will delay the review process. We recommend bringing in the completed intake form to our centre. Once submitted, it’ll be reviewed and you will be contacted about the next steps. 
 
Do not send this form through fax or email, it will not be accepted.
In the meantime, we encourage you to seek alternative agencies to access
other Community Health Centres.