New and Returning Therapist Request Form
Thank you for your interest in Badge of Life Canada and your request to be added to the list of therapists on our website.
Complete and submit the form so your information can be reviewed.
If you are approved, your listing will be added to our website and you will be notified, via email, when it is completed and “live”.
By sending this form, you agree to be added to our Newsletter mailing list.
The questions with an “asterisk” are required. The form cannot be submitted unless all “required” questions are answered. Incomplete forms will not be processed. Address MUST include city, province and postal code.
If you have any question(s), please contact the Executive Director Laura Kloosterman via our “Contact Us” form.
(a new tab will open so you do not lose the information in the current tab).
Attention Therapists:
We are currently revamping our therapist listings to ensure we provide the best resources for Public Safety Personnel and their families.
If you have already submitted a request, please hold tight—we will be in touch soon. If you are newly submitting a request, our team will review it and reach out in due time. Thank you for your patience and for your commitment to supporting those who serve.
