Coastal Psychotherapy Clinic(343) 633-3678info@coastalpsychotherapyclinic.ca Name * First Name Last Name Email * I'm interested in help with * Individual therapy Couples therapy Other Additional Information (Optional) Do you have a specific area or mental health concern that you would like to work on or explore more? I.e. depression, anxiety, relationship matters, intimacy, etc. Phone * (###) ### #### How did you hear about Coastal Psychotherapy Clinic? (Optional) Psychology Today Google Search Social Media (Facebook, Twitter, Instagram) Family Physician Word of Mouth Other Note: Your email will be answered within 24-hours or less. Please check your junk mail in case Gordon's reply lands in there by accident. If you have a preferred date or time to connect, please list a few options in the space provided below. I look forward to chatting with you soon! Thank you! Gordon will follow-up with you within 24 hours or sooner. Please make sure to check your junk mail if an email from info@coastalpsychotherapyclinic.ca landed in there by accident.
