If you would like to begin accessing programs and services at C.M.H.A. H.K.P.R., you can take a first step today by completing our intake form. 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
- Case Management
- Complaints and Concerns
- Four County Crisis
- IAR and OCAN
- Medication Safety
- Supporting your Wellness Booklet
We are pleased to offer additional resources about a variety of topics, including but not limited to the following:
- Bed Bugs
- Cold and Flu Season
- Hand Hygiene
- Our Commitment to Privacy
- OTN
- Safety in Your Environment
- Slips and Falls
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 705-748-6711. If you prefer, you can download the form to fill out and submit.
C.M.H.A. H.K.P.R. Intake Referral Form - Peterborough
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 require immediate assistance, please call Four County Crisis at 705-745-6484 or toll-free at 1-866-995-9933.Note: If you have a concern, please see our Complaints and Concerns page or contact the program manager, Samantha Parnell.