Please complete the Find a Psychologist Referral Service Survey

Thank you for your interest in signing up for our Find a Psychologist Referral Service.
In order to be eligible to join you must be an active member with the Ontario Psychological Association, and registered in good standing with the College of Psychologists of Ontario. 

Please complete all of the applicable fields below. 

If you have already signed up for the Referral Service but wish to update your account, please contact the OPA office at 416-961-5552 or by email.

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* 1. First Name

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* 2. Last Name

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* 3. OPA Membership Number (Will not be listed)

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* 4. Are you currently registered with the College of Psychologists of Ontario?

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* 5. Contact email

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* 6. Website

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* 7. Provide Work Address

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* 8. Provide Work Phone Number

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* 9. Additional Work Address

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* 10. Additional Work Phone Number

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* 11. Gender of Psychologist/Psychological Associate

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* 12. Do you accept Sliding Scale?

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* 13. Do you provide Remote Assessment?

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* 14. Age Group
(Select all that apply)

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* 15. Area of Practice
(Select all that apply)

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* 16. Theoretical Orientation
(Select all that apply)

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* 17. Service Language
(Select all that apply)

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* 18. Service Language Suggestions

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* 19. Area of Concern
(Select all that apply)

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* 20. Area of Concern Suggestions

0 of 20 answered
 

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