Request for Free Counselling
If you are an ACB Woman experiencing depression, anxiety, low self-esteem, grief, feelings of unworthiness, sadness etc... Help is available.  Three free confidential counselling sessions from Black Therapist in either English or French.  Complete the signup process below:
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Confidentiality: Please note that your contact information will only be shared with the counsellor you requested.  Information shared during counselling sessions is confidential between you and your counsellor.  Statistical information only on the demographic groups served such as age groups etc.. (not your personal identifiable information) will be shared with our funder the Canadian Women's Foundation.  All counsellors are licensed and in good standing with their accrediting colleges. *
Required
Your First and/or Last Name? *
Email address Best / Safe to contact you) *
Telephone Number Best / Safe to Contact you *
Best (Safe) way to contact you? *
Can a message be left at this telephone number? *
What options would you like to attend? *
Required
Counsellor Request (please note we will do our best to we will do our best to match you with that counsellor, however, if the counsellor is unavailable, you will be assigned another counselling professional) *
Do you identify as Afro-Caribbean Black (ACB)? *
Current Marital Status? *
Your current age? *
Optional: Do you identify as (select as many as apply to you)?
Thank you for applying. The counsellor will contact you in the next three business days to schedule your appointment. Please note that for each scheduled session that you do not show up, you forfeit a free counselling sessions unless you have notified the counsellor within 3 business days. *
Required
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