Please Fill Out the “Request an Appointment” Form below so we can serve you better.

A very kind and knowledgable person will call you back – in no time at all.

Thank you.

    First Name*

    Last Name*



    Your Age - to find you the best counsellor fit

    Is this for Counselling? - click on box Yes

    Is this for Neurofeedback? - click on box Yes

    Do you have Extended Health Benefits? YES/NO

    If YES, do you know which Benefits Company you are covered with? Enter Company in text box. EXAMPLES:
    Sun Life, Green Shield, Canada Life, Manulife, Blue Cross, Desjardins etc.

    Please SELECT all the professionals your plan covers.

    Registered PsychologistsRegistered Clinical Counsellors - RCC with the BCACCCanadian Certified Counsellor - CCC with the CCPARegistered Therapeutic Counsellor - RTC with the ACCTRegistered Professional Counsellor - RPC with the CPCARegistered Social Workers - RSWSupervised visits by an RCC

    Are you currently in a case with ICBC/WCB? YES/NO

    Please tell us a little of what's happening for you?

    How did you find us?