New Client Form

Thank you for your interest in the Toronto Psychology Clinic!

In order to book an appointment with one of our therapists, please complete the following screening form to share more information about your therapy needs.

Once received, a member of our intake team will get in contact with you regarding next steps and booking an intake call. During the brief 15 minute intake call, our team will be able to collect more information surrounding your needs as well as provide you with information regarding therapists availability and waitlists. If you have a preference for working with a specific therapist, please let the intake assistant know at the time of the call. If not, we will match you with a therapist based on your needs and availability.

By completing and submitting this form you are confirming that (1) you are interested in becoming client at the Toronto Psychology Clinic, (2) We have your permission to store the information you provide us in our secure online database and (3) that someone from our clinic can contact you at either the email or phone number provided.

Your Information

Please note that if there is a voicemail option, we will leave you a voice message. Please do not provide a number where you do not want us to leave you a voice message.

Format

Select your therapy format.

In-Person counselling is not being offered at this time.

Treatment

Select all that apply

*Please note there is a wait list for couples therapy

Primary Presenting Issue

Please share with us the two most significant problems you are looking for help with right now. Please select up to 2 options from this list.

Availability/Scheduling

Please select all of the times of the week that you are available for ongoing weekly appointments. Evenings are considered 5:00 p.m. and later.

  • Monday
  • Tuesday
  • Wednesday
  • Thursday
  • Friday
  • Saturday
  • Sunday

Please note, we cannot guarantee that we will be able to book you immediately.

Preferred Therapist

If there is a therapist(s) at our practice you would like to work with please select. Note that the more options you select, the sooner you may be able to get an appointment, although this will depend on availability and on your specific concerns. Also, if the therapist is not available or is not trained in the area you are looking for help with we will let you know and suggest alternatives.

Meet Our Team

  • Not taking new clients
  • Not taking new clients
  • Not taking new clients
Intake Call Availability

Please select all the times you are available in the next 5 business days to have a quick 15 minute intake call with one of our assistants.

  • Monday
  • Tuesday
  • Wednesday
  • Thursday
  • Friday
Client Acknowledgement
  1. Initial to indicate you understood:

  2. Initial to indicate you understood:

  3. Initial to indicate you understand:

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