moin therapy online intake form

The biographical and contact information collected in this form is legally required under the Personal Health Information Protection Act (PHIPA) and the regulations of the College of Registered Psychotherapists of Ontario (CRPO).

All of your data is transmitted directly to a secure, encrypted digital workspace and is maintained with strict clinical confidentiality. Your information will never be shared without your explicit consent, except under the specific legal limitations outlined in the Practice Guide.