Can we leave a message on the telephone number you provided?
 Yes No

If you will be meeting us over Skype, please indicate your Skype Name.

Preferred appointment time? (Select all that apply)

 Mornings Afternoons Evenings

Preferred day for appointment? (Select all that apply)

 Any day Monday Tuesday Wednesday Thursday Friday Saturday

Which type of therapy are you interested in?

-- Select --Individual PsychotherapyMarriage Therapy and Couples CounsellingAddictions TreatmentFamily CounsellingExecutive ConsultationsProfessional ConsultationsPersonal ConsultationConsultation for Family-Run BusinessUrgent ConsultationDisability Determination AssessmentCognitive AssessmentMedical-Legal AssessmentPsychovocational Assessment for Career PlanningDiagnosis and Treatment PlanningWillpower: How to Strengthen ItLife CoachingBe A Successful IntrovertMindful Eating for Health and HappinessThe Mindfulness ClinicThe Health Psychology ClinicPerinatal Mental Health Service

Would you like to receive information about upcoming groups or events at Clear Path Solutions?

 Yes No