Contact Me

tessa@hopefulhorizonscounselling.com
(877)-290-3937 - no text, only calls available

New clients are welcome. Please fill out the new client form below if you are interested in booking, or contact me directly with any questions about availability.

NOTE: There are inherent confidentiality risks with email communication. While your privacy is taken very seriously, please be cautious about sharing personal information if you are concerned about the potential for breaches that may be out of our control. Contacting me via this website or email implies the acceptance of this risk and acknowledgment of informed consent.

New Client Request Form

Name

First Name

Last Name

Email

Phone

(###)

###

####

Age

Gender

What led you to consider therapy?

What are your goals for therapy?

Are you currently struggling with any of the following?

The items listed below do not align best with my skillset. Checking a box does not necessarily mean I cannot accept you as a client, but I may need to follow up with you to clarify the extent to which I can assist. Depending on your needs, I may also refer you to resources that could be more beneficial for you.

Chronic suicidal or homicidal thoughts

Mania

Psychosis

Problematic substance use

Eating disorder

Violent or criminal behaviour

Excessive lying or manipulation

Severe memory problems

What qualities are you looking for in a counsellor?

Is there anything else you would like me to know about you?