Online Application

Treatment Application Form

Dear Applicant,
Thank you for contacting the TICP Referral Service. After completing the online therapy application form, please click submit.

We assure you that your application will receive careful consideration and will be held in the strictest of confidence. We will contact you promptly with the name of a therapist who is available to meet with you to assess your needs and provide the treatment you require.
Our therapists are not covered by OHIP and therefore the fee for psychotherapy sessions is discussed and determined during your first treatment session. We hope it will be possible for us to help you.

Should we be unable to provide the services you need, every effort will be made to connect you with other agencies or individuals who may be able to do so.

 

Thank you again for using our services.

Sincerely,
Kadri-Ann Laar, Ph.D, C.Psych., Chair
99 Post Rd., Toronto, ON M3B 1J3
E-mail: laarka@sympatico.ca
Naomi Stein, MA
TICP Referral Service Committee

 

Online Application Form

Complete the application for referral form below (online), and click submit when finished. Your form will automatically be forwarded to the TICP Referral Service.

 

TICP Online Referral Service
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  •   Anxiety
      Bereavement
      Confusion about self-image, goals etc.
      Decreased performance at work, home, or school
      Depression
      Health status of myself, or someone I care about
      Memory problems
      Relationship problems
      Problems with alcohol or drug use
      Planning the future
      Concerns about sexual abuse
      Concerns about physical abuse
      Aftermath of a trauma
      Concerns about anger management
      Concerns about the amount of stress you are experiencing
      Thoughts or attempts at suicide
      Concerns about sexual performance or enjoyment

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