If you are a NEW CLIENT, please fill out the fields below and Dr. De Silva will call you to assess your needs as soon as openings become available. After the assessment you will be given instructions for appointment booking.

If you are a RETURNING CLIENT, please fill out the fields below and proceed to booking an appointment using the appointment booking link further below.

If you are a CURRENT CLIENT, please skip the fields below and proceed directly to the booking an appointment using the appointment booking link further below.

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Name: *

E-mail address: *

Telephone number: *

I would like to start therapy as soon as possible.

I can attend between 10:30am & 6:30pm on a weekday.

An email can be sent to the address provided above.

Voicemail can be left at the number provided above.

Symptoms & diagnoses if any:

Issues or problems to address: *

Desired goals of therapy: *

The information provided will be sent electronically to Dr. Nilmini De Silva, will be kept completely confidential, and will be used purely for the purposes of prioritizing client requests and for contacting you.

Note: Fields marked with * are required

Appointments for Current and Returning Clients

PLEASE CLICK HERE TO BOOK AN APPOINTMENT

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