Get In Touch
First Name
Last Name
Email
These are sent to inform you of any special events that may be of interest.
Mobile
May we send you a text message
May we leave you a voicemail?
Preferred method for counselling services
Preferred day for sessions
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Preferred time of day for sessions
I am inquiring about
If relationship counselling
Please enter your significant other’s name, email address, and phone number.
I have their consent to share their info with SOC for the purposes of booking the sesssion
I want a counsellor who is
Do you have funding for counselling?
Will you be using extended health benefits?
Are you interested in our low-cost program?
How soon would you like to be seen
*Please note that we are not a Crisis Center, we work to accommodate sessions quickly on request
Brief description
Please add a few notes about what you are experiencing, what you hope to achieve in counselling
Is there anything else you would like us to note?
Please add additional information to help us find you the nest fit, or any questions you have for us
Do you know of anyone who is currently a client?
If so, what is their name and which clinician do they see? This is to avoid conflicts of interest
I know who I would like an appointment with
Please let us know how you heard about us
Please share the name of who referred you