Appointment request form

Please complete this form to the best of your knowledge in order to direct you to the resource best suited to your needs.

Please specify who will cover the costs of the meetings

Please specify the reason for consultation or, where applicable, the name of the person responsible for the costs of the session (for example: the counselor or a parent)

Protection of personal information (Bill 25)

By submitting this questionnaire, you consent to the collection, use and retention of your personal information by ReseauPsy for the sole purpose of analyzing your request and directing you to the appropriate professional.

This information will be handled confidentially, in line with our privacy policy. You can read it in this section.

For questions about your data, contact our privacy officer at demande.consultation@reseaupsy.ca.