Ray of Hope
659 King St E #230
Kitchener  Ontario  N2G 2M4


Phone: (519) 578-8018
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Referral:
NeurOptimal® Neurofeedback ID
Date: 2025-04-02 04:53
Status: Draft
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Client
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Phone (Home/Main)
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Phone (Home/Main)
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Phone (Home/Main)
Permission to text?
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Email
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Preferred Language
Language Interpreter required
If mother tongue is neither French nor English, in which of Canada's official languages is the client most comfortable?
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Do you have any specific cultural, religious, or other needs that would be good for us to be aware?
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