Booking Form
ABRAR TMH’s Community Counselling Project for Black Women

ABRAR Trauma and Mental Health Services (ABRAR TMH) is proud to deliver a Community Counselling Project for Black Women in Hamilton, Ontario! This trauma-informed and culturally-competent mental health project aims to provide Black newcomer and immigrant women in Hamilton the opportunity to engage in
free one-on-one counselling alongside mental health professionals with diverse lived experiences.

Please fill out this Registration Form with your name and contact information to connect with ABRAR TMH’s Community Counselling Project for Black Women. 
A member of staff will reach out to you within one week of you submitting this Form. 

Thank you!
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Preferred Name/ Initial  *
Email Address *
Phone number *
Which method of contact do you prefer?
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Date of birth? *
MM
/
DD
/
YYYY
Which language would you prefer the one-on-one counselling service to be in?
 *
Would you prefer the one-on-one counseling sessions to be in?
 *
What is your first language?
 *
Do you identify as a Black woman?
 *
What is one thing you hope to accomplish through counselling?
How did you hear about us? *
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