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Refer Someone in Need

If you know someone who is facing life stressors or mental health difficulties and could benefit from our services, we invite you to refer them to Diamond Ecoute. Your referral could make a significant difference in their well-being and provide them with the support they need during challenging times.

How to Refer

Complete the Referral Form: To refer someone, including yourself, to Diamond Ecoute, please fill out our referral form with the necessary information. The form allows us to gather essential details about the individual and their specific needs. We respect the confidentiality of all information shared with us.

Provide Contact Information: Please provide accurate contact information for the person you are referring, including their name, email address, and phone number if applicable. If you are referring yourself, please provide your own contact information. This ensures that we can reach out to them or you and offer our services promptly.

Optional: Personal Message: If you would like to include a personal message along with the referral, you have the option to do so. A few words of encouragement or explanation about why you believe our services would be beneficial can provide additional support and reassurance to the individual or yourself.

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Referrer's name

Client's Details

May we contact the client at this address?


Selected Value: 5

Services receiving / required

Click or drag files to this area to upload. You can upload up to 9 files.

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