Get Support

Request a Counselling Session.

Tell us a little about what you need, and a member of our team will reach out to confirm your appointment. NOPDERVMH provides counselling but does not provide clinical services, diagnosis, medication advice or crisis response.

Not an Emergency Service

This form is not monitored for emergencies and is not reviewed in real time. If you or someone else faces immediate danger, contact emergency services or a qualified local provider in your location.

Confidential by Default

Everything you share here is treated with respect and professional confidentiality.

What Happens Next

A counselor or team member will contact you to confirm your date and time — this form only requests an appointment.

Book a Counseling Session

Please complete this short form to request a session. Your information will be treated with respect and confidentiality.

1. Client Information

2. Counseling & Support Needs

Please share only what you are comfortable sharing.

3. Appointment Preference

4. Additional Information