Note:  This form is for general inquiries.  Please do not submit private health information.

    To request information please complete and submit this form:

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OFFICE LOCATION:
Cobourg, Ontario
​Canada

REQUEST AN APPOINTMENT

Ensuring privacy and secure digital communications is an essential part of providing a safe environment for counselling services.  For this reason I use only secure online platforms and information sharing services for client booking and online video communications.   By selecting the 'REQUEST AN APPOINTMENT' icon below, you will be directed to a secure platform to provide details for your appointment request.  Appointment confirmation and follow up communications will be sent through an encrypted email service. For more information on how your information is protected please refer to the following resource:  www.hushmail.com/about/technology/security/

For additional information regarding remote counselling please see the Remote Counselling page.
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