Veteran Intake

Veteran Intake Form

* Indicates required field

Name *

Date of birth *

VA File Number *

VA CSDN ID Number *

Rank (at time of release) *

How many years of service? *

What branch of the service? *

Cell Phone *

Home Phone *

Email *

Address *

How did you hear about us? *

Please describe what troubles you *

Submit

LOCATION
7071 Bayers Road, Suite 320
(in the Starlite Gallery)
Halifax, NS, B3L 2C2

CONTACT INFO
Phone: 902.406.3400
Fax: 902.406.4775
Email: [email protected]

BOOK AN APPOINTMENT today

HOURS OF OPERATION
Our therapists have varying schedules. We operate Monday to Friday from 9am to 7pm. We offer daytime and evening appointments.

LICENSING BODIES
The Nova Scotia Board of Examiners in Psychology
Nova Scotia College of Social Workers