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. *