Surrey Clinic location:

Intake Form - Surrey Clinic

Please complete the following intake form to initiate the referral process. Upon receipt, our clinic coordinator will contact you by email (unless you request differently) to complete a referral form. Once this referral form is complete and received by us, you will be placed on our waitlist.*Please note our current wait times at the Surrey Clinic: For ASD Assessments, there may be a 12 month wait, for Psych-Ed Assessments, there may be a 3-4 month wait, for Counseling an approximate 9 month wait is likely.
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* 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.