Client Intake Form

Download our Client Intake Form and once it is completed, send to:

Mel Taypotat, Outreach Worker

Box 400.

Fort Qu’Appelle, SK.  S0G 1S0


Fax: (306) 332-1850

If you require assistance with completion of the Intake Form or have any questions about the intake process, please contact Mel by telephone at: (306) 332-5659, ext. 225 or (306) 331-5963