thinking about suicide, 9-8-8 is here to help. Call or text 9-8-8 toll-free, anytime

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Intake – Kawartha Lakes

Intake is your doorway to connecting with our case management team, and our other programs and services. After filling in and submitting the intake form, you will be contacted to meet with an intake worker. Your meeting with the intake worker will help us to understand how you are doing, and how we can best assist you. We will work with you to address immediate concerns, and connect you with other services that may be helpful. Intake can also provide supportive counselling through Brief Services, up to 8 sessions.

Intake Resources

We are pleased to offer additional resources about a variety of topics, including but not limited to the following:

If you would like a physical copy of one of the above brochures, please ask your intake worker or reception.

Get Started

Complete the form below. If you need assistance, call us at 705-328-2704.  If you prefer, you can download the form to fill out and submit.

C.M.H.A. H.K.P.R. Intake Referral Form – Kawartha Lakes 1

Please complete all fields to the best of your ability. If you require assistance completing this form, or require it in an alternative format, please call or ask someone at reception. Please note that it could take up to two weeks until you are contacted by an intake worker. If you are experiencing thoughts of suicide or emotional distress, or are worried about someone you know, call 9-8-8.

  • DD slash MM slash YYYY
  • DD slash MM slash YYYY
    If “other”, please provide the name of the individual who referred you, the agency for which they work and their contact information.
    (For health care provider or caregiver use only)
  • This field is for validation purposes and should be left unchanged.
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