Ready to Get Started?

I offer a free 15-minute consultation to determine if we're the right fit.

Fill out this short form and I'll follow up within 2 business days to discuss next steps.

Request Behavioural Support

Caregiver Information

Full Name *

Email Address *

Phone Number *

Preferred Contact Method *

EmailPhone

Child / Youth Information

Child's First Name or Initials *

Child's Age *

City / Community *

Does your child have any diagnoses or identified needs? (optional)

Funding Type *

How will services be funded?

FSCD-fundedPrivate-payUnsure / would like to discuss

Type of Support Requested

What are you looking for support with? (check all that apply)

Behavioural challengesEmotional regulationSocial skillsAnxiety or coping skillsDaily living skillsParent coaching / consultationCommunity support

Other (please specify)

Brief Description *

Please briefly describe your concerns or goals for support (3-5 sentences)

What challenges are you currently experiencing, and what would you like support with?

Availability

Preferred days/times for support

WeekdaysEveningsFlexible

How Did You Hear About Me?

FSCDReferralGoogleWebsiteOther

Consent & Next Steps *

I understand this form is a request for support and not a crisis service.

Once your request is submitted, I will review the information and follow up to determine fit and next steps.

Trauma-informed behavioural support for children, youth, and families in Calgary, Alberta.

Email: Havenfamilywellnessinc@gmail.com
Phone: (403) 899-3018
Location: Calgary, AB

Haven Family Wellness acknowledges that we are on the traditional territories of Treaty 7 peoples.