Match with a Therapist — Hope Blooms Counselling

LET’S CONNECT

To match with a therapist, you can either fill out the online form OR book a free 15-minute conversation with us to discuss who would be the best fit for you!

Name

First Name

Last Name

Email

Phone

(###)

###

####

How would you like to hear back from us?

Phone Call

Text Message

Email

When would you like to start seeing one of our counsellors?

How old are you?

Is there a counsellor you would prefer to meet with?

The goal of this question is to help our intake specialist match you with the best therapist: Please briefly tell us a bit about what has brought you to seek counselling?

What qualities are important to you in a therapist?

Are you seeking virtual or in-person counselling?

Virtual

In-person

If you prefer in-person counselling but only virtual is available, are you open to that?

Yes, virtual counselling is fine!

I would prefer to wait until in-person counselling is available.

When are you available for counselling sessions? (ex: weekdays, weekends, mornings, afternoons, or evenings)