Skype phone assessment

One‐to‐One Skype or Phone Assessment with our Coordinator of Clinical Services

Give the gift of healing to yourself or a loved one!

Book a one‐hour appointment to discuss and consider your situation and explore choices. The one‐hour appointment may (confidentially) be used to:

Consider and Clarify the impact and severity of any destructive compelling behaviors you may have.

Reflect upon, discuss, and explore your theory of what is ‘going‐on’ and what you need to do to achieve greater happiness

Hear more about neuroplasticity and how early patterns and ways of being developed related to survival can be resistant to change.  But with attention and intention new neural pathways and new ways of being with self and others can be experienced and practiced

Explore options to best address and move forward toward greater balance, wholeness, and happiness.

Skype or Phone Assessment Cost:  $240.00 (plus 5% GST)

For Non Canadian Residents all pricing is in US dollars

Last Name:
First Name:
Address
Suite/Apt no.
City
State/Province
Zip Code
 
Home Tel:
 
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Mobile:
 
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Email (where brief summary of session can be sent to)
Date of Birth
 
Sex

Payment Information

* All Fields Are Mandatory to Complete the Application Form
Billing Address
Is your billing address same as your current address?
Yes, same as my address filled in above
No, different Address
If No, please provide your billing address
Payment Method
  • The three digit security number imprinted on the signature panel on the back of your Visa or MasterCard credit card.

    This three-digit security number is a tool used to help prevent fraudulent use of credit cards. It helps to validate that the customer has a genuine card in his / her possession for Internet or mail order transaction.
I understand that should circumstances prevent me from keeping an appointment, a minimum 24 hours notice is required for any change. I understand all fees are non-refundable and should I miss a session without providing required notice I understand no credit for the missed session will be provided.

 

Fax: 604‐892‐3003
Email: [email protected]
We request Contacting Emergency services in your area if you are in crisis.
This is NOT a therapy session and is not designed for people who may be experiencing acute emotional crisis.
NO recording of this appointment is permitted