Referral Request Form | Tyndale University

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Referral Request Form

Referrals suggested of professionals or appropriate agencies for those who are seeking assistance (i.e. counsellor, psychiatrist, etc.) for self or for friends/loved ones in crisis.

Please note that counselling is available at the Tyndale Family Life Centre for individuals who are not Tyndale students. See the Family Life Centre website for more information including a list of available counsellors, their biographies and their contact information.

First Name *

Last Name

Optional

Email *

Is this referral for *

You

Friend/loved one

Church member/parishioner

What type of counselling are you looking for? *

Individual

Couple

Family

Do you prefer *

Female Counsellor

Male Counsellor

No Preference

Are you specifically looking for a Christian Counsellor? *

Yes

Doesn't Matter

Which area of the GTA would you prefer to see a counsellor in? *

Please provide the specific area (ie. North York, Vaughan, etc.)

Price Range *

Higher End (Usually more experienced therapists)

Mid-Range (You are working and you have some flexibility to pay for counselling)

Sliding fee scale needed (for people who are on fixed incomes, students, single parents, etc.)

Are you looking for a counsellor with a particular area of expertise?

(e.g. anxiety, pornography, abuse, self-esteem, marital issues, pre-marital counselling, etc…)

Is there anything else you would like to mention?

If you do not receive a reply from us within 5 days, please follow up by emailing smcleod@tyndale.ca or calling 416-226-6620, ext. 2123.

Leave this field blank