Book a Consultation Call

Name *

First Name

Last Name

Phone *

(###)

###

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I prefer a counsellor who is:

Female

Male

Whoever is available first

Rachael Curtis

Nigel Mojica

Debra Winter

Ishtar Beck

If the counsellor I request isn't available, I am open to being contacted by a counsellor who is available

My age grouping is:

18-30

30-45

45-60

60+

I am a parent seeking child counselling/play therapy

I am a parent seeking youth counselling

I would like to book a session: *

In person

Remotely

Either way works for me

For my consultation phone call: *

Please call the phone number I provided above during business hours

Please email me to schedule a call

I will check my spam folder, especially if I'm using gmail

I consent to receive a text message (initial contact only)

My preferred times for booking a session are: *

Flexible

Daytime

Evenings

Weekends

If evening and weekend appointments aren't available, I can be flexible