Forms

Instructions

These fillable PDF forms will send the form directly to your clincian for processing and signature.

Click on the start button on the right and side of the form that you are filling out. Follow the instructions prompted in Adobe, and your forms will be submitted to your therapist. If you have any issues or concerns regarding your forms, please reach out to your therapist of contact us via email.

Consent to Disclose Personal Information

Consenting form to release personal information to the psychotherapist and consulting services.

Consent - Adult

Information and consent to adult psychotherapy and consulting services.

Consent - Child

Information and consent to child psychotherapy and consulting services.

Consent - Telehealth

Online counselling and or remote psychotherapy.

End of Treatment Feedback

Client counsellor feedback.

Intake - Adult

Adult intake form for counselling and or psychotherapy.

Intake - Child

Adult intake form for counselling and or psychotherapy.

Intake - Relationship

Relationship intake form for counselling and or psychotherapy.

**Please note both parties are required to fill out a separate form.

Request Appointment

Please include non-medical question and correspondence only.

Frederick Street Office

Monday to Friday: 9:00 am - 5:30 pm (EST)
Saturday: 9:00 am - 1:00 pm (EST)
Sunday:Closed

Victoria Street North Office

Monday to Friday: 9:00 am - 5:30 pm (EST)
Saturday: 9:00 am - 1:00 pm (EST)
Sunday:Closed

Accessibility Toolbar

Scroll to Top