Contact Us

460 Main Street East, Suite 304
Hamilton, Ontario L8N 1K4
Phone: 289-768-0014
Fax: 1-905-234-1515
E-mail:  intake@ay.on.ca

Hours of Operation:
Monday: 8:30 a.m. – 5:00 p.m.
Tuesday and Wednesday: 8:30 a.m. – 8:00 p.m.
Thursday and Friday: 8:30 a.m. – 5:00 p.m.

An intake worker is available Monday to Friday from 9 am to 5 pm at the main office to provide information, consultation and to schedule an appointment. Evening appointments available.

AY Referral Form

Do you think you or somebody you know could benefit from AY services? You can make a referral online using the form below.

    Referred by:

    Name of Referrer (if applicable):

    Telephone Number (if applicable):

    Organization (if applicable):

    Is this person aware of your referral?

    Have they agreed to be contacted?

    Person's Name:

    Person's Preferred Pronouns:

    Self-described pronouns:

    Date of Birth:

    Preferred First Contact Method:

    Telephone Number:

    Email Address:

    Can they be reached by text?

    Address:

    Is this person attending school?
    If Yes – Name of School and Grade:

    Is this person a parent of children aged 0-6?

    Is this person street-involved?

    Would this person prefer to access service:

    Reason for Referral: