Book an Appointment

1. Please provide us with your contact information

Name:
A#:
Contact Email:	* Your email address is required

2. Counselling Concern(s)

Concern for Friend Anxiety Self-Esteem/Confidence Grief/Loss Stress

Depression Relationship Issues Victim of Crime/Assault Other (Specify):

3. How severe are the above concern(s)?

Please be aware that our service may be booked 2-3 weeks in advance. If your concern is pressing or an emergency, please contact 911 or Good2Talk at 1-833-292-3692. These are free, 24/7, confidential phone counselling services.

I am OK to wait until the next availability I can wait a week I need to be seen within a few days

4. Appointments are booked at the following times. Please select all times that would work best for you.

Times	Mon	Tues	Wed	Thurs	Fri
9:00 - 10:00 am
10:15 - 11:15 am
1:15 - 2:15 pm
2:30 - 3:30 pm

5. Do you have a preference for? (We can't guarantee that we can accommodate preferences)

Female Male Does not matter

If you are in crisis or an emergency use one of the following: Good2Talk at 1-833-292-3692, Mental Health Mobile Crisis at 902-429-8167 or go directly to the QEII Emergency Department (19 and over) on Robie Street or IWK Emergency Department (Under 19) on South Street.

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Our Secretary will be back in touch to confirm your appointment date, time and name.

Thank you!