Contact Us

460 Main Street East, Suite 304
Hamilton, Ontario L8N 1K4
Phone: 905-527-4469
Fax: 1-905-234-1515
E-mail:  [email protected]

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 during business hours 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.

    After submitting a referral, someone from AY will reach out to the preferred contact method within two business to advise on eligibility, and next steps.

    Referral Type:

    Referred by:

    Name of Referrer (if applicable):

    Telephone Number (if applicable):

    Organization (if applicable):

    AY Services are voluntary, all clients must consent to the referral

    Is this person aware and agreeable to the referral?

    Person's Name:

    Person's Preferred Pronouns:

    Self-described pronouns:

    Date of Birth (yyyy-mm-dd):

    Preferred First Contact Method:

    Additional Contact Details (best time to call, etc):

    Telephone Number (123-456-7890):

    Can they be reached by text?

    Email Address:

    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:

    Would this person prefer to access service in French: