Our Clinical Director and Client Services Coordinator will have access to the information you provide in this form as they are the ones who will be coordinating the matching process. The information is transmitted and managed through our secure G-Suite platform, but we cannot guarantee 100% security from malware or threats like email phishing.

For immediate support:

1. Youth: Text WELLNESS to 686868.

2. Adults: Text WELLNESS to 741741.

3. Call 911 if you are in immediate danger or need urgent medical support.

4. Indigenous people can also reach out to Hope for Wellness at 1-855-242-3310.