Counselling Service Request Form

Moving Forward offers free short-term and affordable long-term counselling options to underserved communities across Canada via in-person, telephone, and online platforms. We welcome you to our judgment-free environment where you can get the help you need no matter your age, race, identified gender, financial situation, or location. Please fill out the form below.

Please correct the errors described below.

COUNSELLING SERVICE OPTIONS - Please choose either services with Intern (Student on a practicum) or Registered Therapist.

Health Authorities, Education, Corrections and Ministry of Children and Family Development are responsible for publicly-funded counselling, and we do not receive any funding from those sources. We therefore operate on cost recovery. Because we are not funded by government sectors responsible for publicly-funded counselling, we can only offer up to 4 free sessions with an intern to clients who are unemployed.

By submitting form, I acknowledge the following:

I acknowledge that certain services may only be available to me if I am a low income earner. I understand I may be required to provide proof of low income. If choosing to see an intern, I acknowledge that I have not been able to access services through the agencies responsible for publicly funded counselling. I understand that these services have a maximum number of sessions.

I understand that if I am choosing a service with an intern, they may have limited prior experience and cannot offer specialized services, such as psychological assessment. They also will not provide detailed letters for court/probation/social worker.

Once an appointment is made, I will make every effort to attend. I will provide a minimum of 24-hours advance notice if I cannot attend. I understand that missed appointment fees may be charged and/or services will be discontinued if I miss multiple appointments.

I understand that while services are offered across Canada, MFFS is based in British Columbia, Canada, and follows provincial laws related to service agencies.

Formatted text

Your information will be encrypted.