Sexual Assault Centre for Quinte and District

Referral Form

  • 1 in 2 people who identify as female and 1 in 4 people who identify as male will be sexually assaulted in their lifetime
  • Sexual violence is about power and control
  • Most sexual assaults are committed by someone the survivor knows

Complete Step 1 of the Registration Process by filling out the referral form below.

Talk to someone now.
Toll-free at 1-877-544-6424

If you require immediate help,
please call 911.

Any survivor of sexual violence, 16 years of age or older, residing in the province of Ontario is eligible to apply to the Residential Healing Program at the Paths of Courage Healing and Retreat Centre. The application process is described below.

Step 1: Referral Form

Please fill in the form fields below in the referral form. You can send this website page link and have your support worker fill it out and sign it (i.e., mental health worker, addictions counsellor, sexual assault worker, psychiatrist, doctor, etc.).

For your convenience, you can alternatively download and complete the Referral Form (PDF) version of the form here and send a copy to us through email at [email protected], by fax to (613) 476-7708, or mail it to us (please call us for physical address).

"*" indicates required fields

This field is for validation purposes and should be left unchanged.
Required fields *

Referral Information

MM slash DD slash YYYY

Participant Information

Participant Name:*
MM slash DD slash YYYY
Address*

Participant History

Max. file size: 32 MB.
Will you continue to support the client upon their return from the POC program?*
Consent*
Signature of Referring Party*
Clear Signature
MM slash DD slash YYYY

How Can I Help?

There are many ways to help through donating, volunteering, or by hosting a fundraising event. Learn more here on how you can help.

Help Now

Get Support

Access support here for individual counselling, support groups and our lending library.

Get Support Now

The Paths of Courage

The name 'Paths of Courage' refers to four paths of healing, developed out of the vision for a holistic approach to healing from sexual violence.

Path of Physical Well Being

Path of Physical Well Being

  • During the program week we will offer participants a variety of tools that they can use to experience connection with their physical self.

    + READ MORE

    • Exercise — yoga, stretching, hiking, kayaking, snow-shoeing, challenge course, movement therapy.
    • Nutrition — plenty of nourishing food provided.
    • Relaxation — time to de-stress built into each day, plenty of time to rest in a quiet country atmosphere.
    • Connection — through physical activities, drumming, and community.

Path of Emotional Balance

Path of Emotional Balance

  • Our participants will get a chance to recognize, experience and embrace feelings and emotional states as true barometers for life experience. These are:

    + READ MORE

    • Group process — using tools of role-playing, somatic body work, projection/reflection and boundaries.
    • Support — from peers, professionals and self.
    • Trust building — through various exercises designed to challenge individuals and build community and trust.

Path of Re-thinking

Path of Re-thinking

  • Often experiences of sexual abuse lend us distorted belief systems that diminish and influence our daily life. Cognitive re-structuring allows participants to look at the thoughts that drive their lives and re-negotiate those beliefs that negatively impact their sense of self.

    + READ MORE

    We help to introduce you to:

    • Reframing — a process that ends or diminishes those nagging, negative thoughts.
    • Healthy communication — learning ways to assertively reinforce boundaries and resolve conflict
    • Positive reflection — being able to see self differently as reflected by peers and staff.

Path of Spiritual Connections

Path of Spiritual Connections

  • Through all the other paths of courage, survivors may be able to connect to their own spiritual understandings and their right to wholeness and happiness.

    + READ MORE

    We do this through:

    • Connection to nature — outdoor activities, a beautiful tranquil environment.
    • Quiet and solitude — some time each day to journal and reflect
    • Creativity — through art and music making
    • Ceremony and rites of passage — honouring our time together and the sense of connection that a healing community inspires
    • Meditation — guided mediation to turn inward and encourage healing
    • Sacred Healing Fire — Facilitated by a local Indigenous Fire Keeper

Stay Informed

View all News & Events
Meditation Sound Bath

Meditation Sound Bath

→ CONTINUE READING
Donate a Car

Donate a Car

→ CONTINUE READING
"Sexual assault is a serious, pervasive crime in our community. The deeply wounding effects of sexual assault ripple through our society, taking a toll on physical and mental health and family life, and affecting an inner sense of self."