Contact Us

appointment request form

Name*

Email*

Date of Birth DD/MM/YYYY*

Do you live in Lethbridge? Y/N*

Type of Service Requested (Individual, Couples, Family)*

Are services for you? Y/N And if No, who are they for?*

Do you extended health benefits? Y/N If yes, who is your benefits provider?*

Are you seeking subsidy to help pay for counselling? Y/N

How would you like to attend counselling? In person/virtually/telephone?*

Are you requesting a specific therapist and if no, do you have a preference of gender for who you meet with?

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Lethbridge Counselling Services

740 4 Avenue S, Lethbridge, Alberta T1J 0N9, Canada

Suite 207 (Professional Building) Phone: 403-942-0452 Fax: 403-942-7576 Email: lethbridgecounselling@gmail.com

Hours

Monday - Friday: 8AM–9PM

Saturday - Sunday: 9AM-2PM

Forms

Please review, fill and sign ahead of your appointment and return by email to your therapist.

Your therapist will also review and discuss the consent form at your first appointment and answer any questions you may have.

LCS consent form (Under 18) (pdf)

Download

LCS consent form (Adults) (pdf)

Download

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