New Clients

Ready to take the next step?

Fill out our new client inquiry form below to be matched with one of our experienced and friendly counsellors. If you’d like to meet with a specific counsellor, simply indicate so on the form where prompted.

We’re here to support you on your mental health journey!

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Name*

Phone*

Email*

Can we leave you a voicemail

Yes

How would you like to hear back from us?*

Gender*

Where are you located?*

If you selected other above, please let us know where you are located below:

What services are you interested in? (Check all that apply)

Counselling

Workshops

Empowerment Programs

Is there a particular counsellor/practitioner you would like to meet with or would you like us to find the right fit for you?

What is your reasoning for reaching out today?**

What type of appointments would you prefer?*

Your Availability

If you are looking for counselling, please let us know the type of appointment you are looking for

How will you be paying for your appointments?

How did you hear about us?*

If you were referred by someone, please let us know who below.

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Name

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New Clients

Ready to take the next step?

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