Pre-Registration for Let's Talk ADHD

I am pre-registering for the: Adult ADHD Group:

Please Provide Your Contact Information

Preferred Name:

Your Date of Birth – Please complete (dd/mm/yyyy): *


Gender Pronouns:

Gender Pronouns – Other:

Do you have a diagnosis of ADHD?

When were you diagnosed with ADHD (month/year)? Any other diagnoses?:

Have you received any interventions to address your ADHD, such as medication, counselling, etc.?:

What do you hope to learn in the Let’s Talk ADHD group?

How did you hear about the Let’s Talk ADHD group?:

Starting January 1, 2023, the cost of this program will be $600.

If you are paying by eTransfer, please payment send to [email protected] In the message, indicate your name and the program name you are registering for.

If you are paying by credit card, please call Reception at 403-686-9300 Ext. 100, Monday to Friday, from 8:30 AM to 4:30 PM.

We have funding available to help those impacted by the COVID pandemic. Please complete the questions below if you require financial support for this program.

Because of the pandemic, I have been impacted financially:

Because of the pandemic, my mental health has been impacted:

Please explain how the pandemic has impacted you:

Our Program Coordinator will be in contact by email to confirm registration.

If you have questions or concerns about Adult ADHD Group, contact Jaime Gaber by email.

CanLearn may transfer personal information to outside service providers that perform services on our behalf such as client relations management systems, or similar services. These service providers are located and store data in Canada. By providing personally identifiable information to us, you agree to the transfer of your personal information to a server located in Canada. More information about our privacy policies and practices can be accessed by contacting Laura Godfrey at 403-686-9300 ext. 126 or by clicking here.