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Tel. 519-289-0148    Fax. 519-289-0149   Toll free 1-800-328-2616
EAGLE WATCH CRISIS INTERVENTION 519-289-9090
TENDING THE FIRE
CARING FOR WATER
APPLICATION

Kiikee Form

FNTI Application 1

FNTI Application 2

FNTI Application 3
FAMILY APPLICATION
(PDF Format)
PROGRAM CALENDAR


Please complete all forms and
fax to the attention of:

Tracey Whiteye
(519) 289-0149
TENDING THE FIRE/CARING FOR WATER
APPLICATIONS
PROGRAM CALENDAR
STAFF CONTACT
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INTAKE APPLICATION
TENDING THE FIRE
CARING FOR WATER
PAGE 1A - Initial Profile

PAGE 1B - Shareholder Information

PAGE 1B2 - Shareholder Information, Pt. 2

PAGE 1C - Shareholder's Children Information

PAGE 1C2 - Parent/Guardian Information

PAGE 2A - Health Questionnaire

PAGE 2A2 - Negative Cognition Questionnaire

PAGE 2B - Release of Information Form

Items to Bring

We have developed the following intake process in order to be fair to every individual that would like to attend our Traditional Healing Program.

  1. We will notify you by fax, e-mail, or mail to inform you that we have received your application and that you have been placed on a waiting list.

  1. Then, when the next program is available for you and/or family, you will be contacted for a telephone interview.  Upon completion it will then be assessed what program may be suitable for you.

  1. You will receive a Confirmation Letter from the Intake and Assessment Worker to state you have been confirmed to attend a specifically dated program, which will be the validation on your participation in the program.

Please complete all 3 forms and
fax to the attention of:

Crystal Flewelling
(519) 289-0149
APPLICATIONS