Application Form for Admission to Youth Program
To be considered for admission to our Youth residential treatment program, the following form must be completed:
NOTE: To view this form, you must have Adobe Reader installed.
Please forward the completed form as follows:
Female Applicants: Female Youth Services Fax: (204) 275-2099 |
Male Applicants: Male Youth Services Fax: (204) 482-9717 |
If you require assistance in completing these forms, or have questions concerning admission to our Youth treatment programs, please contact the Behavioural Health Foundation Youth Services through one of the following methods:
Female Youth Services: Jennifer Larner, Intake Inquiries Telephone (204) 261-6111 |
Male Youth Services: John Moore, Intake Inquiries Telephone: (204) 477-6878 |
