Welcome to Amanda Tobe & Associates!

New Client Consultation form

Please complete this form to schedule your consultation
Please share your full name *

First NameLast Name

Please share your e-mail*

Please share your phone number*
Please enter a valid phone number.

Please indicate whether your phone number is a Canadian number. (If you select "No," please note that you will need to make arrangements with your therapist to connect via Zoom for your appointments.)*

YesNo

What is your age range?*

under 1818-2930-4445-5960+

What would you like support with? (Please select all that apply)*

Career counsellingPublic speaking anxietySelf-confidenceWorkplace stress or relationship challengesGoal-setting and concentrationPresentation CoachingInterview CoachingOther

If you receive extended health care benefits, please select all types of providers you have access to:*

Registered PsychologistRegistered Social WorkerRegistered PsychotherapistSpeech and Language Pathologist

What brings you here today? Feel free to share up to 3 things you’re working on, wondering about, or trying to tackle.*

Are you interested in joining one of our Therapy Group sessions?*

Public Speaking GroupImposter Syndrome GroupCareer Clarity GroupIndividual Support Only

How did you find out about us?*

Google searchPsychology TodayReferred by family or friendReferred by physician or healthcare providerInstagramAI querieOther

By selecting "Agree," you acknowledge that this form will be reviewed by our administrative staff and practitioners. You also consent that the practitioner may take notes during your consultation.*

Agree

Would you like to be added to my mailing list about new blog posts, resources, workshops, and latest news in my practice?*

YesNo
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