Questions followed by an * are required Please read our COVID-19 Update here https://aulneau.com/covid-19-update/ If you only want to register for a wellness check and not register for counselling sessions, please fill out this form.
I would like a wellness check by telephone for myself*
- Yes
- No

Client's Name*
First Last
Client's Primary Phone Number*
Is it safe to leave phone a message?*
- Yes
- No
Client's Email Address
Would you like to have this service conducted in English or French?
- English
- French
What time of day would you like your wellness check phone call?
- Morning
- Afternoon
- Evening
Terms of Service
Terms of service*
- I acknowledge and confirm that I have read the Wellness Check Terms of Service.
An Aulneau Renewal Centre counsellor will be in touch with you as soon as possible .
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Wellness Check – COVID-19

Terms of Service