Forms

Program Requirements At The Stables Grounds:

  1. Proof of current / prior employment
  2. Be currently employed or retired as a Community Public Safety and Security Personnel, Canadian Armed Forces, Veteran and / or a Front-Line Health Care Provider (Fire, Paramedic, Police, Nurse)
  3. Be able to participate in individual and group therapy in a community environment
  4. Be able to manage basic personal safety

Imporant:

The submission of these forms begins a pre-screening process and does not guarantee admission to the program.  All information will be held as confidential and will be stored securely.

If you have any questions, please do not hesitate to contact our Program Director at [email protected].  We are available Monday thru Friday from 8:30 am to 5:00 pm.- excluding holidays.

Please complete these forms and return via fax to:   (905) 727-5312.

After receiving and reviewing forms, one of our staff will contact you by phone to review the details and have an informal discussion.

PRE-Admission Instructions:

  1. 4 (four) Forms to be completed by you

2. 1 (one) Form to be completed by one of the following: Physician, Psychiatrist, Nurse Practitioner

3. Supply “Proof of Employment” Current and or Past. Group or Company ID is required (one of the following)

  • ID Badge, Pay Stub, Business Card with ID, Members Card, Company Letterhead Permission

Payment Options:

For private payment option please contact [email protected]

To determine coverage please consult with your insurance company, EAP, benefit provider or employer directly.

A quote for services will be provided upon successful review of your forms and eligibility.

Intake and Weekly Survey:

  1. Admitted guests are kindly asked to complete this survey upon arriving, and again once weekly during their stay (required password will be provided to you)

Program Evaluation Survey:

  1. Admitted guests are kindly asked to complete this evaluation survey at the end of their stay (required password will be provided to you)