• Contact us here!

Client Registration Form

In order to maximize your time at your first appointment, we encourage you to complete the following registration form in advance. While every effort is made to keep your information confidential, we cannot guarantee confidentiality with online registration. If you prefer to register over the phone, you may call us directly at

905-431-5654

    Personal Information


    MaleFemale


    Voicemail?YesNo

    Text Message?YesNo

    Preferred Communication?PhoneTextE-Mail

    Emergency Contact Information






    Other Information



    YesNo
    If Yes, list them here:

    YesNo
    If Yes, list names here:

    YesNo
    If Yes, list them here:

    Presenting Concerns

    Please check all that apply:
    Substance AbuseAnger/FrustrationAnxiety/WorrySchool/Work ProblemsRelationshipsSleep DisturbancesSuicidal ThoughtsDepressionFamilyGriefLife TransitionSeperation/DivorceStressEmotional DistressMotivation


    Onyx Therapeutics – Come Talk With Us!
    Psychotherapy Services
    Warmth. Collaboration. Growth.

    101 Mary Street West, Whitby, ON
    Tel: 905.431.5654
    E-mail: hello@onyxtherapeutics.ca

    All Rights Reserved ® Onyx Therapeutics 2019