Fraser River Counselling

If you would like to receive counselling services,

Online Intake Forms


How It Works

  • Click on the following links to fill out the intake form that matches the type of counselling services you want. 
  • The link will take you to our online intake form, where you will fill it out and submit it.*  This will take about 10 minutes to complete.
  • You will then receive an email confirmation from the Intake Worker within a 1-3 days.

*You will need an email address to complete the intake form online.  If you do not have one, phone the intake worker to complete an intake over the phone. Also, if you would rather complete an intake over the phone, contact the intake worker.

2 Child/Youth Counselling Intake Form(18 years of age and younger)

  • Once you submit your intake, you will receive an email confirmation.
  • Within a few days, the intake worker will notify you of the waitlist and provide details regarding the next steps.
  • Your intake form will then be placed on the waitlist.
  • When your intake reaches the top of the waitlist, a counsellor will be given your form.
  • Your intake form is securely stored with the intake worker until your counselling commences.  If you have questions, please contact the intake worker.

It is advisable to submit your online intake in a private, secure place.  Using a Public Wi-Fi Network does not protect your privacy and confidentiality.  Choose to do so at your own risk.

Before You Begin

Please read through the What to Expect section and our Privacy Policy before completing the intake online.  This is where we provide important information about our program and the services we provide, as well as how we maintain your privacy and confidentiality.

please fill out an intake form.

What Happens to my Intake Form?