Rainbows Canada has folded but now we are busy developing a new similar local program. Learn more.

Prism Registration Form

Your Information

Complete Legal Name Required

Address

Phone Number Required

Marital Status

Your Children (Name / Age / In Rainbows?)

Email Address Required

Loss Information

What are the losses you would like help with?

When did the losses occur?

How have your losses affected you?

Have you been in counseling and/or therapy? *

If "Yes", have you informed your counselor/therapist that you are registering in this Prism group?

Confidentiality

I promise not to disclose anything shared in this support group.

I Agree

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1088 Gillet Street
Prince George, BC
V2M 2V3