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Get help from VICCIR

Request Counselling Support

Complete this secure referral form for yourself or, with their permission, for someone else.

This form is only for referring immigrants or refugees who are currently living in British Columbia to VICCIR. Please be advised that, depending on demand, it may take up to 4 weeks for us to respond. If you have any difficulties with this form, please call or email us ( 778-404-1777 info@viccir.org).

1. Submit

Share referral details

Tell VICCIR who needs support, how to reach them, and what kind of help may be needed.

2. Review

VICCIR reviews the request

Staff review the situation, discuss fit, and identify suitable counselling and language support.

3. Connect

Arrange next steps

VICCIR contacts you to discuss matching, fees, and the next available step.

I am referring... *

Referral information

Referral date *

Your information

Date of birth *

Contact Information

Immigration status

Date of entry to Canada *

Languages

Interpreter needed for English?

Reason for referral

Please select all that apply:

Any other information?