HELP CLIENTS
FIND YOUR PRACTICE
During COVID-19, our therapists offer virtual therapy via phone or video to keep you safe. However, if you have a strong preference to meet with your therapist in-person, identify so in your client intake form and we will match you with a therapist that offers in-person sessions during this time.
FIND THE RIGHT
THERAPIST FOR YOU
Need help finding a therapist? Get matched
We match you with a therapist that will give you the best chance at overcoming your challenges.
Complete our intake form to get your top therapist recommendations, based on the factors that matter.
Complete our client intake form today!
GET MATCHED TODAY!
Review Who We Serve to make sure you qualify for Kinthera matching. Then follow the steps below:
1.
Complete all 6 sections of the client intake form below, review, and submit.
2.
RECOMMENDATIONS
We will send you your top 5 best matches within 2-3 business days.
3.
BOOK YOUR FIRST SESSION
Every therapist has a preferred way to schedule in clients. We'll include how to book your first session!
Prefer to get matched over the phone? We can do that!
If you do not want to submit your information through our online client intake form, we are happy to complete the process over the phone. Schedule a match meeting with us here.
CLIENT INTAKE FORM
Please complete all 6 sections below. Review answers before submitting.
Contact Information
Must provide either email or phone number
Emergency Contact Information
Location & Transportation
Would you like a therapist that you meet with:
Required
Do you live in Canada?
Do you live in Ontario?
Required
Required
Currently, we only serve clients in Ontario, Canada
Currently, we only serve clients in Ontario, Canada
What town will you be travelling from to get to your therapy sessions?
Please note we currently only offer therapists in the Waterloo Region (Kitchener, Waterloo, Guelph, and surrounding areas). If you are too far to travel to these locations, you will only be able to meet your therapist match virtually via phone or video.
Insurance & Cost
Do you have insurance coverage to help you pay for therapy?
What type of therapists does
your insurance cover?
Required
What is the most amount of money you are able to pay for each hour of therapy?
Required
Please note that some therapists provide a sliding scale. This means that your results may include some therapists slightly out of this price range, as they may be able to reduce their costs depending on your personal financial constraints.
Personal Demographics
Primary/native language(s):
Other languages you fluently speak:
Do you identify as being strongly affiliated with/practicing any particular religion?
What ethnicity/ethnicities do you identify as?
Diagnosis/Reasons for Therapy
Select all reasons why you are seeking therapy:
Please provide at least one diagnosis/reason for therapy
Anxiety related
Mood related
Abuse related
Trauma and stressor related
Abuse, dependence, or addiction related
LGBTQ+ challenges or concerns related
Ethnicity or culture related
Relationship or relational
Personality disorders
Physical health related
Sexual health related
Eating or body image related
Life events or well-being
Other
If you have any other diagnosis/reasons for therapy we have missed, provide them here:
If you have any other therapy style
preferences we have missed, provide them here:
Therapeutic Modality (optional)
It is important to note that all therapy styles are equally as affective. However, if you have a deep preference for one or more specific types of therapy, please select here:
Please complete the following fields:
Your intake form has been received! We will be in contact within 1-2 business days.
Congratulations on taking the first step!
We look forward to matching you with the best therapist for you
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