Forms

I ask that on your first session, you arrive a few minutes early with the necessary paperwork (see below) completed.  I will need these for my files.  Please let me know in advance if you do not have access to a printer.  We can arrange then to have you arrive 20 minutes ahead of time in that case so I can provide you with the paperwork and you can complete it in the waiting room.

Please note there have been changes to the consent forms below as of April, 2019 regarding privacy and security.

Clients are not required to provide consent for email and text communication.  I am happy to discuss both the benefits and drawbacks.

Cortney Pasternak, Information Package and Informed Consent Form

Counselling Website Intake and First Session Orientation Form

Consent to use email, text form

Telephone, Online Consent Form

Consent for Release of Information

Email: cortney@ontariotherapist.com

Conveniently located office:

287 Main Street West, Hamilton, Ontario (In-between Queen and Locke Streets). Free parking in the back of the building or metred parking across the street. Entrance in the front.  Waiting room through the front door to the right.  Please note that I operate a scent-free office to protect people with allergies and sensitivities, and will ask all clients to remove their outer footwear before entering the office.  I require 48 hours for cancellations to avoid a fee, and I accept cash, visa and interac e-transfer for payment at the time of the appointment.