Reduced Rate Services Form

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Please ensure you've reviewed our eligibility requirements before completing this form.

Our professionals reserve a limited number of spots within their caseload for clients who require reduced rate services. These services are subject to whether a professional has capacity to accept clients at a reduced rate. Because our professionals have a varying capacity to offer sliding scale, the one you request may not be able to accept you immediately. You have the option to be referred to one of their colleagues at Aroha Pride Counselling or to be placed on a waitlist.

Email *

Are you seeking services from the first available provider or a specific provider? Please indicate specific provider in the "other" section. *

First available provider

Other:

Are you a parent or caregiver seeking counselling for your child? *

Yes

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