Ask us for help

Welcome to VillageHelps. If you have a need that you’d like our help with, please fill out the following form and we will contact you right away. All information you provide will be kept completely confidential. You can also call us at

647-724-0157

VillageHelps Client Application Form
Your name (*)

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Home telephone number

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Email (*)

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Briefly tell us a bit about the situation you are in (*)

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What led you to seek out the assistance of VillageHelps?

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Address

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Cell phone number

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Date of birth (MM/DD/YY) (*)

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Briefly tell us how we can help, now and moving forward (*)

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How long would you expect to need our help?

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Please type the characters you see below
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Confidentiality

One of the core commitments at the heart of VillageHelps is our desire to provide a safe venue for individuals to seek assistance and care. We understand that many of the situations and issues we may face in the daily outworking of our projects will require a highly confidential approach. Therefore, it is our policy (both individual and corporate) to use information only for the purpose for which it was provided and to not disclose information regarding a client without their expressed consent. You are entitled to review, and, if required, seek amendment to any confidential information about yourself that is in our possession.