Youth Referral Form

Please complete the fields below. Please note the information collected in this form is confidential and secure, and will be directed to our intake worker. We will respond to your referral within one business day. For any questions, please contact our intake worker at intake@siws.ca.

If you prefer to download a paper copy of these forms, please select your preferred format before. Please note, you will have to complete the forms once they’ve been downloaded, and then emailed as an attachment manually to intake@siws.ca or fax to 778-426-2998.

Family Referral Form

For families currently involved with the Ministry of Child & Family Services.

Please complete the fields below. Please note the information collected in this form is confidential and secure, and will be directed to our intake worker. We will respond to your referral within one business day. For any questions, please contact our intake worker at intake@siws.ca.

If you prefer to download a paper copy of these forms, please select your preferred format to download. Please note, you will have to complete the form once they’ve been downloaded, and then emailed as an attachment manually to intake@siws.ca or fax to 778-426-2998.

Support Worker Form

For general support requests and one-to-one support for adults. For example: addictions, mental health, resource connections etc.

Please complete the fields below. Please note the information collected in this form is confidential and secure, and will be directed to our intake worker. We will respond to your referral within one business day. For any questions, please contact our intake worker at intake@siws.ca.

If you prefer to download a paper copy of these forms, please select your preferred format to download. Please note, you will have to complete the form once they’ve been downloaded, and then emailed as an attachment manually to intake@siws.ca or fax to 778-426-2998.