Request Intake Session

Name *


Age *


Email *


Phone *


Address *


Services Interested In*
PsychotherapyNeurofeedbackBoth Psychotherapy & NeurofeedbackPsychological Assessment

Clinician Preference*
NoneDr. Michelle PresniakAllison WoodSharon KaderDr. Katie BendellDr. Danielle BouchardJennifer CieslakKristen FennellWendy Lange-FariaTina WilstonMarielle ButovskyJenn McNultyJade FergusonMichelle AntwiSandy BothamKaytlin HennigarChelsea WhyteSarah Grummet

Preferred Ottawa Location*
DowntownKanata

Referred By


Presenting Problem