Eterna Counselling – Therapist Match

INTERESTED IN BOOKING A SESSION BUT NOT QUITE SURE WHICH THERAPIST TO WORK WITH?

TAKE THE QUIZ AND WE WILL GET BACK TO YOU SOON WITH YOUR MATCH!

A successful counseling experience has to start with a good fit between you and your therapist.

Name *

First

Last

Email *

Please enter your email, so we can follow up with you.

Phone Numebr *

Can we leave a voicemail? *

What counselling service do you require? *

In-Person Required
In-Person Preferred (Virtual Okay)
Virtual Preferred/Required

Who is the counselling for? *

Myself
Child or Youth
Other

How old are you? *

Tell us a bit about why you are reaching out...

What are some of the issues you're currently struggling with and would like to work on? (i.e.; relationship, trauma, family, grief, depression, anxiety, etc.)

What type of counselling are you looking for? *

Individual Therapy
Couples Therapy
Child/Youth Therapy
Family Therapy
Other

What type of people do you get along with best?

Do you get along best with people who are straight to the point, caring, loves to laugh, serious, etc.?

If you have been to counselling before, what did you like most about your counsellor?

I.e., they challenged me, they gave me homework between sessions, they were able to hold space well, they used a particular theory, etc.

Preferred appointment days and times? *

Monday to Friday (Mornings 8am-12pm)
Monday to Friday (Afternoons 12pm-4pm)
Monday to Friday (Evenings 4pm-8pm)
Saturdays (9am-4pm)

Who do you want to work with? *

Registered Clinical Counsellor ($130-$150 per session)
Registered Social Worker ($130-$150 per session)
Counselling Intern *Waitlist for September* ($60 per session)

If there is anything else we should know, add it here!

How did you hear about us? *

*while our email is encrypted, please limit the amount of disclosure included in this form for confidentiality purposes. Also, please check your spam folder, our emails sometimes find their way there