Thank you for your interest in working with me! In this form you will find a list of services and associated costs, as well as a summary of the process for assessments. When you are ready to move forward, please fill out the attached form. Your information is stored securely and is used to plan the services.
Please make sure to read the information on my website (services page) before completing this form, as it contains important details of my service.
Please fill out all applicable sections; If there are sections missing this may cause delays.
If you are an individual 16+, I will be reaching out to you directly.
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Services and Costs
Psychoeducational Assessment $2225
Comprehensive Psychoeducational Assessment (psychoed +more learning or psychoed +mental health) $3150
ADHD assessment $1125
ASD Assessment $1575
Comprehensive ASD Assessment - $2700
ASD Comprehensive Assessment + Psychoeducational or + Mental Health - $3600
Mental Health Assessment – $1125
Counselling/Consultation - $225/hr
First, complete the form below. I will review your information and if I can take the case, I will email you with an estimated timeline and to initiate the intake process. If I cannot take the case, I will email you with referral options.
The intake process involves completing the file with relevant documents, including consent forms, background forms, and copies of report cards and/or other professional assessments if applicable (e.g. speech and language, neuropsych, OT, previous psychoeducational, etc.) These documents get reviewed before the intake meeting to help me plan the services.
Once the file is complete with these documents, we will go ahead with booking an intake meeting. For assessments, we will further discuss the assessment procedure for your specific case, including which tests will be used, number of testing days, etc. at the intake meeting. For counselling, the intake meeting is an introduction and get to know each other session.
Client/Child Current Age:
Client/Child Primary language
Completely bilingual; equally comfortable in both language
English primary; preference and most comfortable in English
French primary; preference and most comfort in French
Client/Child Language of Learning
English and French
Comprehensive Psychoeducational Assessment (+ more learning or + mental health)
Comprehensive ASD Assessment
Comprehensive ASD Assessment + more learning or + mental health
Mental Health Assessment
Description of Presenting Issues and Concerns:
For clients over 16: Client email
For clients over 16: Client phone
Clients 16+: Contact preference
Please contact me directly
Please contact my parent/guardian
Please contact other
Parent/Guardian #1 Email
Parent/Guardian #1 Phone
Parent/Guardian #2 Name
Parent/Guardian #2 Email
Parent/Guardian #2 Phone
For clients under 16: Parents & Custody arrangement
Parents are married and share custody
Parents are separated and share custody
Parents are separated and one parent has full custody or only one parent can make medical decisions
A guardian has legal custody
How did you hear about me?
Online search (e.g. google)
Referral from another professional
Referral from school
Name of referring school, professional or person:
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