Intake Packages


The intake paperwork is required to assist us in matching your needs with a student clinician and to better understand the population served by the PSC. Normally, services are provided by graduate students in Clinical Psychology who are supervised by Registered Psychologists. All services are provided at no charge.

Please click on the links below to access our Intake Packages. A link for a particular service will only be available if our waiting list is open for that service. Currently all our waiting lists are open in preparation for the coming academic year, which starts in September.


Intake Package for Adults


Intake Package for Children/Adolescents

Couple and Family:

Intake Package for Couples/Families

Group Treatment:

We are now accepting referrals for our Overcoming Anxiety in Pregnancy and Postpartum Group Treatment program with the first group starting on October 17, 2019.  Please call 204-474-9222 for more information.

Note: Please hand write the forms instead of typing them.

Once you return your completed Intake Package to the PSC it will be reviewed to ensure it is a case that we can provide services for. If accepted, your name will be added to our wait list. Please return the Intake Package to the PSC by mail, fax, or by dropping it off at our office. We ask that you do not send it by email as it is not a secure form of communication for personal health information.

Mailing Address:
Psychological Service Centre
University of Manitoba
161 Dafoe Building
Winnipeg, Manitoba
R3T 2N2
Phone: 204-474-9222

Fax: 204-474-6297 (Please note that our fax machine is located in a private area but we ask you to call us first before faxing your Intake Package so we can make sure we receive it.) 

*We are not able to provide services to clients seeking reports for Child and Family Services or reports for the courts because these cases are not suitable for student clinicians.*