Application for Service

Getting Started

CMHA Huron Perth Addiction and Mental Health Services offers a range of services for those seeking supports for Addiction and Mental Health concerns.

Please do not complete this form if you are currently in crisis. If you are in immediate crisis, please call the Huron Perth Helpline and Crisis Response Team at 1-888-829-7484.

If you are ready to get started, please fill out our brief form below and we will be in touch as quickly as possible.

Privacy Statement: The following form will ask for personal identification information to help connect Users with activities, services, features, or resources we have available. All personal identification information from Users is voluntarily to submit. Users can always refuse to supply personal identification information, except that it may prevent the agency from being able to engage with Users. By completing this form below, you consent to CMHA Huron Perth Addiction and Mental Health Services to contact you for the purposes of providing services, resources, or information regarding the agency or its affiliated programs and services.

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Your Name

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Address

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