TPC New Client Form

Hello, and welcome to the Toronto Psychology Clinic – we're here to support you on your mental health journey! This intake form is designed to help our caring Intake team understand more about your unique therapy needs.

After completing this form we will contact you via email or phone with some therapist options to consider.

Questions or just want to chat? Call us at 416-551-1759 ext. 2 or drop us a line at intake@torontopsychology.com. We're here for you!

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What province do you reside in? *
Please note, our clinicians are not allowed to provide services to anyone whose residency is outside their jurisdiction (e.g., where they received their professional license). 
Do you have a preference for virtual or in-person appointments? *
Most of our therapists are offering virtual sessions via a secure Telehealth video-conferencing platform, called JaneApp.
If you want to be booked with a therapist who is covered under your insurance plan for registered health professionals, please check all that apply. If unsure, we STRONGLY RECOMMEND you check your insurance plan to expedite booking an appointment.
Treatment Type *
Are you looking for the following mental health services?
Primary Concerns *
Please share with us what you are looking for help with right now.  If you find more than 4 options below apply, please select only the top 4 concerns and elaborate on other concerns under 'other'
Required
Is there any additional information we need to know when matching you to a therapist?
First Name *
Last Name *
Date of Birth *
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Phone Number *
Email Address *
How did you hear about us?
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