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Please let us know in which Province you reside:
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Please let us know if you are a: (Please select one)PatientCaregiverFamily Member of a Patient
Please let us know your preference for the conversation.Please select one: I prefer to meet: Via TelephoneIn Person at Wellspring Birmingham Gilgan HouseIn Person at Wellspring Westerkirk HouseIn Person at Wellspring Downtown TorontoOnline, via video conferencing (Skype)No Preference
Please let us know the best time to contact you for this appointment:MorningsAfternoonsEarly EveningsAnytime
Lastly, is there any further information you wish to share at this time to help us schedule your appointment?
Thank you. You can expect to hear from Wellspring within two business days. Thank you.