2022 FSCA Adult or Parent Only Counselling Online Intake & Pre Survey with Screening

Step 1 2022 Adult or Parent(s) Counselling Intake & Pre Survey with COVID-19 Screening

  • To book a FSCA Counselling session - Individual, Couple, Family - each adult planning to attend the session please complete the following Single Session Therapy and Pre Survey form.
  • MM slash DD slash YYYY
  • FSCA Client information on current COVID-19.
    For Counselling Session Fee: please choose best applicable option. This can further be discussed during Intake review process and/or with the therapist.
    *Please note Counselling Practicum Interns can not provide credentials to sign on receipts to be submitted for possible reimbursement. They may be able to offer a reduced session fee through United Way funding based on financial hardship criteria.
  • Please pay the session fee online or over the phone prior to the session, on the session date or if required within 24 hours after the session - please note this to your therapist. If not received within 24 hours after the session an Invoice may be texted or emailed to the client. Thank you for your attention to this.
  • MM slash DD slash YYYY
  • **Please Note: clients with gmail.com, yahoo or hotmail email accounts - please check your Spam/Junk Folder for FSCA Counselling emails. Thank you
    FSCA Therapists do not get involved in legal issues - they may make referrals for this to other agencies.
    FSCA Therapists do not have a contract to work with this agency and may be able to make a referral.
  • Please answer the following Pre Survey questions as they assist agency program funders, thank you. Please complete if this is an Intake for Individual, Couple or Family Counselling. Thank you.
    This is for short term immediate intervention counselling.
  • Physical or Emotional IntimacyPersonal StressAlcohol / DrugWork / School StressMarital Separation / DivorceOther relationshipsParentingGriefHealth / Mental HealthSuicideIntimate Partner Violence (child abuse, senior abuse, ect, past or present)AssaultTraumaJob LossOther
    1 being the most important...4 being the lesser important
    The session day/time clients choose may not be the Actual booking day/time.
    Please be aware that we have trouble Sending/Receiving emails to Gmail, Hotmail, Yahoo and Outlook accounts due to technical issues beyond our control. We are able to text to all cell phones.

Contact Details

Main Office:

Family Services of Central Alberta

5409 - 50th Avenue

Red Deer, Alberta

T4N 4B7

Office Hours

Main Office:
8:30am – 4:30pm

Extended hours on Monday/Tuesday:
5:15pm – 8:00pm

Toll Free: 1-866-414-3722

Email us: fsca(at)fsca.ca

Park Plaza Intergenerational Centre

5214 - 47 Avenue, Red Deer

Visit by appointment only Phone: 403-967-0171

Parkland Mall Kinsmen Family Play Space

Hours of Operation:
Monday - Friday
9:30am – 3:00pm

Parkland Mall:  4747 - 67th Street, Red Deer