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Refer your students to Real Campus today. 

We understand the limits that might prevent you from supporting a student as much as you’d like. Luckily, we’re here to help.

If you are supporting a student that is eligible for Real Campus, please complete the form below and we can reach out to them directly to provide them therapy, specialized counselling, and more. 

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Complete Form

Fill out the form below in less than a minute.

Verify Eligibility

We’ll verify the student’s eligibility.
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Access Services

We’ll reach out to the student immediately.

Complete the form below to get started!

  • Referrer Information

  • Student Information

  • Date Format: DD slash MM slash YYYY

  • Requested Services

    Please note that if the student is looking to access on-demand therapy or virtual doctor visits, ask them to visit realcampus.ca/maple and register.
    Please ensure that contact information is provided in the fields above.
    Due to factors around confidentiality and privacy, please note that we will only tell you when we have reached out to the student and not if the student has actually used the service.
    I hereby acknowledge that the student has provided informed verbal and/or written consent to complete this referral on their behalf and that the above information is true the best of my knowledge.
  • This field is for validation purposes and should be left unchanged.