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Non-Waitlist Waitlist Form

This form is to be completed if you are interested in receiving services from Hammond Psychotherapy Services. 

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First of all, we are so honoured you've thought of us! Thank you! 

 

Housekeeping details: 

 

Please know that this is not a waitlist and does not guarantee access to services but allows us to reach out to you when there is an opening. 

 

Please know access to service depends on fit and availability. We also cannot guarantee a timeline and always encourage you to continue to seek out a therapist who is a good fit. 

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Thank you again for your interest in our services and we hope to be in touch soon! 

What is your appointment availability - please indicate all times/days when you could commit to coming for therapy. Please know that this will be a regular thing so choosing a time that you can reliably count on, will be key for you to feel better. 

 

Please note that there are no evening nor weekend appointments for the foreseeable future. You will receive services in a more timely fashion if you have a flexible, day time availability. 

Check all that apply:

Briefly - what are you looking for help with?

 

Please know that Hammond Psychotherapy adheres to the College of Registered Psychotherapists of Ontario's standards of practice in ensuring client confidentiality. Please be aware that this form is not on a secure server and others may be able to gain access to this information without Hammond Psychotherapy's, or your knowledge. Therefore, it is advisable to limit this information to practical content only. 

I am looking for:
Who are you looking to see?

Do you have insurance coverage for "Psychotherapy" or therapy with a "Registered Psychotherapist"? 

 

We do not direct bill to insurance, so if you plan on utilizing your insurance it is recommended you contact your plan provider to confirm this as each session cost is $160-$200 tax inclusive. 

 

This is an investment in yourself and would be a shame if you found out after the fact if you were not prepared to pay out of pocket. 

Select an option:

Would you like to be added to our mailing list? 

 

We like to send fun emails out monthly with tips and strategies in non-therapy lingo. We also let people know of any openings and will often send some worksheets out or other resources we think may be helpful. 

 

We will never sell your info and you can unsubscribe at any time. 

I know this does not mean I am on a waitlist, nor does it guarantee me access to therapy with Darrell or Amanda. *

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