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Menu
  • Find Help
    • If You Are In Crisis
    • Getting Started
    • Programs & Services
    • The Support Line
    • Bereavement Services
    • Supportive Information Sessions
  • Find Info
    • Register for Programs
    • My Sisters’ Place
    • Impact Junk Solutions
    • Mental Health
    • Addiction
  • What We Do
    • Public Education
    • Get Involved
    • Events & Fundraisers
  • News
    • News & Announcements
    • Service Updates: COVID-19
  • Who We Are
    • About Us
      • Leadership
      • Board of Directors
      • History
    • Student Placements
    • Volunteer at CMHA TVAMHS
    • Work With Us!
    • Contact & Locations
    • Privacy Statement
  • How Can You Help?
    • Ways To Give
      • Make A Donation
      • Legacy Giving
      • Donation Wish List
      • Donation FAQ
    • Fundraise for CMHA TVAMHS
  • English

Intake & Access Forms

These forms may be completed for virtual intake or in advance of in-person intake.

Addiction Intake Forms

Addiction Intake Form – Client

Addiction Intake Form – Family or Significant Other

GAIN Screener (To be completed after Intake Form)


Mental Health Intake Forms

Mental Health Referral Form – Downloadable 

Addiction Transitional Case Management Intake Forms

ATCM Intake Form

ATCM GAIN Screener 

LiUNA 1059 & LiUNA 1089 EAP Intake Forms

EAP Intake Form

EAP GAIN Screener

EAP Family Screener

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