Name *

First Name

Last Name

Appointment Availability *

Mornings Between 9 :30 am - Noon

Afternoons Between 1:00 pm - 5:00 pm

Evenings Between 6:00 pm - 8:00 pm

Appointment type: *

In Person

Virtual

Either

Are you looking to use insurance? *

Yes

No

Are you open to working with a graduate student counsellor? *

Yes

No

Undecided

What counsellor qualities are you seeking? Select all that apply. *

Warm & Understanding

Direct & Engaged

Solution-Focused

Compassionate & Sensitive

Sense of Humour & Outgoing

Practical