Rockmanor Mental Health and Psychotherapy Service Inquiry Form
  • This form should take approximately 2-3 minutes to complete.
  • Please do not disclose any specific personal health information as part of this inquiry.


Offering a client-centered, solution-oriented, caring and compassionate psychotherapy service.
  • Service limits: For non-emergency, non-urgent mental health and well-being needs.
  • Service is for individual psychotherapy (1:1), for adults 18+.
  • Service involves 3 phases (1) initial screening, (2) psychotherapy assessment, and (3) psychotherapy treatment. Screening is the first step before anyone may become a client at the discretion of the registered psychotherapist.
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This is a short form for self-referral inquiries. This form will ask about your call back and scheduling preferences, and information shared is for the purpose of enhancing the quality of information for you.
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