Referrals Accepted Complete the form below.

Fortune Shopping Center

#36-750 Fortune Dr.

Kamloops, BC
Above the BMO.

Mon - Fri: 10:00am to 7:00pm

Saturday: Closed

Sunday: Closed

First name

Last name

Phone

Birthday (Clients)

Year

Month

Day

Company name/Organization

How would you the person prefer to be contacted?

How are you known to the person you are referring?

What are you hoping to get out of therapy?

What are the main areas of concern?

What days and times work best for sessions?

Referral Sources:
Self
Parent and Youth
Parents
Counsellors
Not--for-Profits
Organizations
Clinics
Dr. offices
Professionals
Social Workers
Family Members
Shelters

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