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Book Your Intake Appointment

If you'd like to book a an intake session or make a referral please fill out the form to the right.

Note:

You do not need a formal diagnosis to work with our practitioners and we do not provide formal assessments, diagnosis, prescriptions or Applied Behaviour Analysis (ABA) therapy.

#318 - 1175 Cook St,
Victoria BC

V8V 4A1

info@neurodiversityfamilycentre.com

1 (778) 906-8626

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I understand that written consent is required from all of the legal guardians of children & youth 18 and under, and that I must submit a custody agreement if applicable
If you have extended medical coverage, who does it cover?
How do you prefer to receive services?
What Services Are you Looking to Receive? Required
Potential or official diagnosis of client
What days are you available for support?
Do you have a gender preference for your practitioner?

Thank you for contacting us. Please check your junk folder for intake@neurodiversityfamilycentre.com if you've not heard from us in 24 hours. 

Parking:

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Free parking is located around the side of the building for up to 2 hours. 

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Sunday Appointments: 

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Please wait outside the doors if you are unable to get in and your practitioner will be down to let you in.

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Please note all information on the following form and any subsequent information you provide will be forwarded to our intake coordinator and your recommended practitioner(s). 

Individual Contacts

Connection. Education. Support.

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