DBT Centre of the Fraser Valley

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Adult DBT Program

Adolescent DBT Program

Frequently Asked Questions

Treatment Registration

Adult DBT Program

Adolescent DBT Program

Frequently Asked Questions

Treatment Registration

Folder: Services

Adult DBT Program

Adolescent DBT Program

Frequently Asked Questions

Treatment Registration

Treatment Registration

If you’d like to schedule an intake assessment, please complete the service request form and we will connect with you directly with further instructions.

We are not an emergency service. If you require immediate assistance, please call 911 or attend to your local emergency rooms.

Program Interested: *

Adult DBT Program

Adolescent DBT Program

Name *

First Name

Last Name

Preferred Name (If applicable) | Parent Name (for Adolescent Programs)

Age *

Email *

Primary Phone *

(###)

###

####

Secondary Phone

(###)

###

####

Primary Concerns *

Are you currently taking medication? *

Yes

No

If yes, please specify:

Family Doctor *

Preferred Contact Method *

Email

Phone

Okay to leave voicemail? *

Yes

No

Do you have access to extended health coverage? *

Yes

No

Have you ever participated in mental health services before? *

Yes

No

Have you ever participated in DBT before? *

Yes

No

If yes, please specify where and when:

How did you hear about us? *

*

I am fully aware that all programs offered by the DBT Centre of the Fraser Valley are in-person only.

Thank you for connecting with us. If you have additional questions, please feel free to contact us at (604) 239-0109 Ext. 8.