First Name *

Last Name *

Phone *

Email *

Who is this for?

Myself

My Child (13+)

Other

Please note that we do not provide services for children under the age of 12.

I'm looking for the following services

Psychotherapy

Group Therapy

Workshop or Speaking Service

Other

Please note that we do not provide Psychoeducational Assessment (including ADHD and Autism Assessments) at the moment. Please note that we do not provide support in legal matters (e.g. civil or criminal court proceedings, becoming involved in employer-employee disputes, union work, etc.), nor do we act as expert witnesses in a court of law.

Clinician Gender Preference?

Female

Male

No preference

Communication Preference?

Text

Email

Call

Do you have preference for virtual or in-person services?

In-person only

Preference for in-person, but could do occasional virtual session

Open to both

Preference for virtual, but could do occasional in-person session

Virtual only

How did you hear about us?