Name*
Email*
Phone*
Consultation Type* Online/ ZoomIn-PersonPhone
Type of Therapy No PreferenceACTAEDPCBTEFTERP (OCD)EMDRIFSMindfulness-BasedPerson-CenteredSolution-FocusedVarious
How did you hear about us?* Web SearchFriend or FamilyDoctor/ Nurse Practitioner/ NaturopathCounsellor/ PsychologistAllied Health Professional (Physio, RMT, OT, etc.)University Counselling Services (e.g. UBC, SFU)AI Assistant (e.g. ChatGPT, Claude)Other
Name of referring professional (if known)
Your Availability* Weekday Mornings/ AfternoonsWeekday EveningsWeekends
Your Availability* Weekday Mornings/ AfternoonsWeekday Evenings (Limited)Weekends
Your Availability* Weekday Mornings/ AfternoonsWeekends
Your Availability* Weekday Mornings/ AfternoonsWeekday Evenings
Your Availability* Weekday Mornings/ AfternoonsWeekday Evenings (Limited)
Your Availability* Weekday Mornings/ Afternoons
Your Availability* Weekday EveningsWeekends
Your Availability* Weekends
Message* Do not use this form if you are in crisis or require immediate support. Please call the BC crisis line 604-872-3311 or go to your nearest hospital emergency room.
470 Granville St, #922 Vancouver, BC, V6C 1V5
Mon – Fri: 09:00 – 21:30 Sat – Sun: 09:00 – 20:30
604 828 9508 connect@arccounselling.ca
