Counselling Inquiry

Thank you for your inquiry regarding counselling support. You can take the next steps toward receiving counselling or access support groups by completing this registration form. This form provides us with essential preliminary information so that we can send you more information in the area of your interest.

If you would prefer to speak to us by phone, please feel free to contact us at 647 534 2764 Ext 324 or email us at care@thebridgemarkham.com so that we can setup a time to speak with you. Please allow 24-48 hours for us to get back to you. If you are in distress and need immediate assistance, please call 911 and follow their instructions. Thank you.

Your name *

Email address *

Phone number *

Address *

Are you currently attending The Bridge - A Markham Community Church

Yes

Are you in a LifeGroup at the bridge?

Are you currently employed? *

Yes

Do you have Insurance Coverage? *

If not covered, OHIP covered counselling can certainly be accessed

Yes

Is there anything particular that you would like us to know about the type of counselling you would like to access?

Personal information, etc.

Would you be interested in attending a seasonal support group that may meet your need?

Support groups don’t have a weekly session fee. We’ll be glad to send you more information about the support groups that are being offered.

Yes

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