Getting Started
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
Intake Process
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 Name:
Client/Child DOB:
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Client/Child Current Age:
Client/Child School
Client/Child Grade
Client/Child Primary language
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Client/Child Language of Learning
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Service requested:
Description of Presenting Issues and Concerns:
For clients over 16: Client email
For clients over 16: Client phone
Clients 16+: Contact preference
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Parent/Guardian Name
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
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How did you hear about me? *
Name of referring school, professional or person:
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