First-Time Client Form

Shalem Counselling Services

We welcome you to Shalem Counselling. Please complete the following form.

First-Time Client Form

May we leave a message at this phone number?

What is your preferred method of contact?

What type of sessions are you looking for?

Are you accessing us through a Church, School or Organization that has a program with us?

Do you have insurance to access a Registered Psychotherapist or Registered Social Worker?

Will you require an appointment after regular business hours?

Do you prefer an online/virtual appointment?

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875 Main Street East
Hamilton, ON L8M 1M2
905.528.0353 • 1.866.347.0041
[email protected]

All inquiries will be held in the strictest confidence.
For urgent and/or emergency matters, please call 911 or visit your local emergency department. If you are in Hamilton, please reach out to COAST at 905.972.8338.

Counselling is made possible by many donors, including the The Edith H. Turner Foundation through the Hamilton Community Foundation.

Funding for the Counselling Assistance Fund has been provided in part by the ArcelorMittal Dofasco Employee Donations Fund.

The views and opinions expressed in this website do not necessarily reflect those of ArcelorMittal Dofasco or the ArcelorMittal Employee  Donations Fund.