Forms & Printables
Practical mental wellness resources designed to support clients, families, and community partners.
Practitioner Referral Form
Referral form for agencies and practitioners to securely and efficiently connect clients with counselling services at Galia Wellness Services.
Simply email the completed form when ready to begin the intake process.
*Click Image to download PDF*
Self Talk Poster (purple)
A calming, purple-themed printable poster that invites you to reflect on compassionate self-talk, and encourages you to pause and speak to yourself with kindness and understanding.
*Click Image to download PDF*
Self Referral Form
A confidential self-referral form that allows you to request counselling services with Galia Wellness Services.
Simply email the completed form when ready to begin the intake process.
*Click Image to download PDF*
Printable Poster
Poster for clinics and community spaces promoting
Galia Wellness Services and accessible outpatient psychotherapy in northern Manitoba.
*Click Image to download PDF*
Safety Plan
A structured safety plan template designed to help individuals identify coping strategies, supports, and clear steps to enhance personal safety during times of distress.
*Click Image to download PDF*
Self Talk Poster (blue)
A calming blue-themed printable poster that warmly encourages you to pause, breathe, and offer yourself the same understanding, patience, and kindness you would give to someone you care about.
*Click Image to download PDF*
Tri Fold Pamphlet
Foldable Pamphlet
showcasing Galia Wellness Services.
Great for clinics and schools to have on hand.
*Click Image to download PDF*