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Name *

First Name

Last Name

Phone *

(###)

###

####

Are you open to virtual therapy? *

YES

NO

Do you have benefits? *

YES

NO

Will cost be an issue?

(The cost per individual session ranges from $120 to $222)

YES

NO

Who will be paying for sessions? *

Me

Another family member or guardian

Me and another guardian (shared custody)

Children's Aid Society (CAS)

Victim Services (Victim Quick Response Program -VQRP)

Jordon's Principal (Non-insured health benefits for First Nations and Inuit)

Afternoon, evening and weekend sessions are the most requested sessions and may result in wait times for service. Are you able to attend sessions during the business hours of Monday to Friday, 9 AM to 5 PM?

YES

NO

We offer two consultation options to suit your needs:

Free 15-Minute Consultation: A quick, introductory session to meet your therapist, discuss your needs, and determine if it's the right fit.

50-Minute Consultation Session: This in-depth call brings together thoughtfulness, intuition, and compassion. It includes assessment, feedback on results and discussion, collaborative planning, and the creation of a personalized path that aligns with your or your family’s unique needs. Together, we’ll explore your goals with warmth and care, providing guidance to support your journey.