Referral Form

Name*

Last name

Email*

Address

Phone*

Please click outside of the box to add phone number.

How would you like us to contact you?*

I am looking for services for:

Me/myself

My Child (4-12)

My Teen/ Young Adult (12-18)

Another Adult

Other

My child's first name and age is:

Please provide us with some basic information about the areas we can help you with:

I found Acorn & Anchor

In a web search

Referral from a friend/family member

A list of therapists (like Psychology Today)

An IFS network

A Facebook group or page

Thanks so much for connecting with us!

*Forms are sent directly to the Centre from our website.

Please note, as with all online communication, there are risks and benefits and AATC can not be held liable for issues resulting in security and privacy issues.

**Check your email folders (junk and others) for our response please!**

Disclaimer regarding GOOGLE and other Reviews:

Acorn & Anchor Therapy Centre follows professional standards and ethical practice above and beyond those required. Confidentiality and privacy of personal information is fundamental. Professionals are unable to respond to public comments , nor can we confirm or deny whether an individual has contacted the centre, is a client of the Centre or a person who has never made contact or received services from us.

Main Office: 1562 Bloor St. West, Toronto ON, M6P 1A4

We're ready when you are! Contact us

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Acorn & Anchor Therapy Centre 1562 Bloor St. West, Toronto, Ontario

Referral Form

Acorn & Anchor Therapy Centre
1562 Bloor St. West, Toronto, Ontario