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Mental Health (Counselling) Self Referral Application

Please know your application form will be reviewed within 3-5 business days, you can expect a call from the Central Lambton Family Health Team to book your appointment then.  If this is a Mental Health Crisis please go to your local Emergency Department or call 911.  

The CLFHT provides structured short-term clinical services to those experiencing challenges in their life. Our focus is to provide treatment that is educational & motivates the individual towards developing goals and skills that will support their mental & emotional well-being.

You can download and complete the PDF and bring it in, or fill out the form below.

Download Intake Form

Online Form