Name *

First Name

Last Name

Phone *

(###)

###

####

What services are you interested in? *

Individual Psychotherapy

Screener Tests

Marriage & Couples Therapy

Family Therapy

Preferred Psychotherapist(s) *

You can choose to book a consultation with more than one.

Aastha Jain, MA, MPhil, RP

Adnan Zoubi, MA, RP (6 Month Waitlist)

Bolour Kalibar, MA, RP

Bronwen McCann, MA, RP (Qualifying)

Cydney Lebovitz-Hoffman, MPsy, RP

Jeff Driscoll, MPsy, MPsy, RP (Qualifying) (6 to 8 Week Waitlist)

Oren Ogniewicz, MPsy, RP (Qualifying)

Any Male Psychotherapist

Any Female Psychotherapist

No Preference

I consent for the Centre for Psychodynamic Insights to contact me through phone and email, and leave a voice message. *

Yes

I understand that all sessions are conducted virtually only over video call or phone calls based on your preference. *

Yes

I have checked the session rates and have sufficient insurance coverage or personal funds for potential future sessions. *

Yes