Richmond Clinic location:

Intake Form - Richmond Clinic


Please complete the following intake form to initiate a referral and/or to join our wait list. Upon receipt, one of our clinic coordinators will contact you to discuss next steps. Please note that there is a waitlist for all assessments and availability is limited at this time in our Richmond location

Is there another email that you would like correspondence sent to as well (e.g., another parent)?
Address line, City, Province, Postal code
We are required to have consent from all legal guardians in order to provide services. If this is a concern, please let us know as soon as possible.
Required by the College of Psychologists of BC, the BC Association of Clinical Counsellors, and the College of Speech and Hearing Health Professionals of BC.
Please note that ABLE Clinic is not able to provide psychological services if guardianship is in active dispute and all parties do not consent to services.
Please note, we do not do direct billing for extended health benefits.
Supervised practitioners often are available with shorter wait times and most bill a lower hourly rate than registered professionals which can reduce the cost of services. Supervised practitioners are not yet registered with the College of Psychologists of BC and are closely supervised by Registered Psychologists here at ABLE Clinic. You will not be charged for the cost of this supervision.
Please put "N/A" or equivalent, if there is no relevant history for this item or the next.
Providing this information will help us assign the appropriate clinician to support/assess your child.

* Please note, we cannot guarantee the confidentiality of information transmitted through e-mail including the intake form.  Please be aware of this limitation when contacting us.

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