Consultation & Workshop Request — Northwest Wellness Counselling

Let’s work together

Interested in working together? Fill out some info and we will be in touch shortly! We can't wait to hear from you!

Name

First Name

Last Name

Email

E-mail Address

Phone

(###)

###

####

Tell me a little about yourself and/or organization

Tell me a little about yourself and/or organization?

What services are you interested in?

What Services are you interested in? Please click all that apply.

Workshop & Training

Speaking Engagement

Organizational Culture Shift

Leadership Coaching

BIPOC Healing Space

Objective

What is your objective for the service(s) requested?

Who benefits?

Which individuals or departments will benefit from the consultation(s)? (e.g., frontline staff, clinical teams, clients, leadership, etc.)

Budget

What is your budget for service(s) requested?

Time Commitment

Please provide the preferred date(s) and time(s) for the consultation, as well as the estimated time commitment required.

How did you hear of us?

How did you learn about us?