Submit a Referral

Please use the form below to refer someone for counselling.

Name of Referral:

Date Of Birth:

Current Care Professional:

Your Name:

Your Phone Number:

Your Email Address:*

My primary reason for seeking Counselling at this time is:

Restrictions to my availability include:

Our office is located on the traditional, ancestral and unceded lands of the Sḵwx̱wú7mesh Úxwumixw (Squamish), Stó:lō and Səl̓ílwətaʔ/Selilwitulh (Tsleil-Waututh) and xʷməθkʷəy̓əm (Musqueam) Nations

Our Location

145 15th St W #303,
North Vancouver, BC
V7M 1R9

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Operating Hours

Monday – Friday: 9:00 AM – 9:00 PM

Saturday: 9:00 AM – 5:00 PM

Sunday: 10:00 AM – 4:00 PM

Phone Hours

Monday – Friday : 9:00AM – 3:30PM

(Please leave us a voicemail and we will get back to you as soon as possible)

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Connect with Us

Call us: (604) 904-0898

Email: info@bachcounselling.com

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