Online Registration – HEAL – Hope Exists After Loss Youth Program

Information collected on this authorized form complies with the Privacy Act and Personal Health Information Protection Act. Scarborough Centre for Healthy Communities (SCHC) collects information to assist with program planning, improvement of services, and research. This information is confidential and shall not be used for purposes other than those for which it was collected, nor shall any identifying information be sent externally, except with your expressed consent or as required by law. Answering questions marked optional is voluntary. We encourage you to discuss any questions or concerns you may have with one of our staff.
Occasionally, staff may take photographs of participants in the program. Photos are used internally within the program or externally in displays promoting the agency/program or in the agency newsletter.

* Indicates required field

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Yes consent to pictures of me being taken and displayed No do not consent to pictures of me being taken and displayed

Age *

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Today's Date (MMDDYYYY) *

Do you live in Scarborough? *

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Name *

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How did you hear about us? *

What is your race/ethnicity/cultural origin(s)? *

Why are you interested in this program? *

SUBMIT

IMPORTANT: Maintaining the community’s health and safety are our priority. Please be mindful for the following SCHC IPAC guidelines we will be following for in-person programming:

Location will likely be in Scarborough, Ontario
Travel reimbursement and light refreshments available if in person
COVID-19 Practice in Effect – Pre-screening, Masks, and Physical Distancing Required
A designated screening station will be setup
All participants are required to undergo screening and temperature checks with a touchless thermometer
Participants that have symptoms of COVID-19 will not be able to participate in programs. They will be asked to get tested at the local assessment center
Participants MUST wear a non-medical face covering
There should be a minimum of two meters distance between participants and staff, using visual markers
We will have alcohol-based hand sanitizer available for use at the screening station.

Contact Olivia Brooks, Youth Bereavement Coordinator, olbrooks@schcontario.ca

To view more information on our Bereavement Care programs, please click here.

Online Registration – HEAL – Hope Exists After Loss Youth Program

Contact UsPhone: (416) 642 9445Email: info@schcontario.caScarborough Centre for Healthy CommunitiesCharitable # 13036 4276 RR 0001

Contact Us
Phone: (416) 642 9445
Email: info@schcontario.ca

Scarborough Centre for Healthy Communities
Charitable # 13036 4276 RR 0001