We encourage you to take the time to share with us some outline information that will help us to understand your situation and respond back to you. Please try to avoid giving just 'yes' or 'no' answers. This is an opportunity to share with us so that we understand. We're listening and taking you seriously!

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Contact Information

Personal Information

Situation Information

The information you give is confidential between you and YLC. We need this information to be able to assess your situation and determine whether we are a good fit for your support needs just now or whether we need to refer you to a partner agency with more experience/ specialism in your situation. You agree to YLC responding / communicating with you via email.