Intake Application/Forms

 


 

Download the Intake Form

Please fill out Intake and Referral forms and send completed package to Nimkee NupiGawagan Healing Centre.

 


 

Here you can download the Intake Form and all the Referral Forms with one click.

 


Referral Forms

Covid-19 Data Collection Form

SOAHAC Consent to Release or Obtain Info Form

Tele-Mental Health Form

Nimkee NupiGawagan Healing Centre would like to thank SOAHAC, Thunderbird Partnership Foundation, YSAC, MCCSS for providing their valuable input in developing these forms.

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