Let’s work together

Therapy hours: Monday – Friday 10:00am to 5:00pm EST

Name

First Name

Last Name

Phone

(###)

###

####

What service are you interested in?

Free 15-minute intro phone call

Initial Assessment (1 hour)

CBT-E Assessment (2 hours)

Follow-Up Session (50 minutes)

Parents' Session (25 minutes)

Parents' Session (50 minutes)

Consultation (50 minutes)

Consultation for Professionals (1 hour)

Preferred Date

YYYY

Other preferred dates and times (EST)

How did you hear about me?

Your confidential message:

This is not an emergency or crisis service. In the event of an emergency or if you are in crisis, call 911 or go to the nearest hospital emergency room. If you need immediate support, you can also call 9-8-8, the Canadian Suicide Crisis Helpline for 24/7 support.