Contact

We are a digital counselling agency and do not provide in person sessions. Are you able to attend sessions online?*
- Yes
Are you seeking counselling for yourself or someone else?*
- For myself
- For someone else
Reason for seeking services*
Have you (or the person you’re filling this out for) had counselling in the past?*
- Yes
- No
Please specify if the outcome was positive or negative:*
Where did you hear about us?*
If known, what is their name?
If known, what is their name?
If known, what is their name?
If known, what is their name?
If known, what is its name?
If known, what is their name?
Please specify where you heard about us

Do you know anyone who is a current, or was a past, client of ours?*
- Yes
- No
If possible, please share their name and if you know who they are working/worked with.
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