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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


    Personal Information



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    Other Information

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    Presenting Concerns

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    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

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