Please Call (18886916111), e-mail  (infocmap@hushmail.com) or book with a therapist directly online from our website

Contact Us for Help
Alberta: 330 5TH Avenue SW, Suite 1800 Calgary , AB T2P 0A4 (Virtual only, in person coming soon)

Private psychotherapy referral form

Psychotherapy by our therapists is not covered by Provincial Healthcare. However, it is covered by most major insurance providers.

Please upload your referral letter

Or fill out this form

SECTION A: REFERRER DETAILS
SECTION B: PATIENT INFORMATION
SECTION C: CLINICAL DETAILS
Please include all previous patient investigations for mental health treatment such as psychological tests and lab tests relevant for assessment.
IF POSSIBLE, PLEASE INCLUDE ALL PREVIOUS PSYCHIATRY/PSYCHOLOGICAL ASSESSMENTS