Mental Health FormsCreate Your Own

Mental Health Support

We are pleased to launch our mental health supports for children, youth, and adults. We will also be offering parenting support for parents and caregivers who are helping their children with mental health challenges. Our mental health supports are for residents of Toronto. This form is considered confidential. No information in this form will be shared with anyone outside of the Parents of Black Children team without your consent. A copy of this form can be sent to the email you provided upon submission if you request it.


By completing this form, I consent to have this information, including personally identifying information, shared with the Parents of Black Children Mental Health Support Services. We will be offering Single-Session (one-off) Therapy. One-Off Therapy is where the client and thearpist agree to meet to help the client deal with a specific concern in one session. The intention of this therapy is to help the client in one- single session and additional resources will be provided if neeeded. Do you agree to this consent and the Single-Session therapy?

Mental Health Form Questions