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Start your path to well-being by completing our Therapy Intake Forms. These forms allow us to gather information to ensure our services will meet your mental health needs. Therapy Intake Form Welcome to Our Clinic! As part of our intake process, we ask you to help us understand the reasons you are seeking our services. Please complete the following fields: Contact Information I’m seeking services for How did you hear about us? Do you have extended health benefits coverage? Do you have coverage from FNHA, Autism Funding, or other? What type of therapy service are you looking for? Do you have a preference for a clinician? Why are you seeking therapy services? Please check the box for any symptoms that apply and provide a brief description if needed. Internalizing Behaviours: Anxiety Symptoms: May include concerns such as worries about small details, striving for perfection, fears related to social situations, specific phobias, and physical symptoms like stomachaches. OCD Symptoms: Could involve unwanted recurring thoughts, repetitive behaviours, or avoiding certain places or situations. Body-focused Repetitive Behaviours (BFRB): Might involve hair pulling, skin picking, nail biting, or other similar repetitive behaviours. Low Mood: Possible symptoms include feeling irritable, lacking energy, appearing sad, isolating from others, and feeling hopeless. Trauma Related: Potential experiences of physical or sexual abuse, witnessing violence, or being involved in a serious accident. Externalizing Behaviours: ADHD Symptoms: Might present challenges in focusing, impulsive actions, or overly active behaviour. Impulsive or Non-compliant Behaviour: Could include acting without thinking and resisting following directions. Defiant Behaviour: Might be characterized by refusing to listen to authority figures and frequently breaking rules. Rule-breaking Behaviour: Could include truancy and involvement in fights. Risky Behaviours: Might include self-harm, discussions of suicide, or threatening violence. Developmental Concerns: Autism Spectrum Symptoms: Possible difficulties with social skills, a preference for routine, and sensory sensitivities. Developmental Delays: May involve not meeting age-appropriate developmental milestones. Other Specific Concerns: Social Challenges: Issues could involve making or keeping friends and facing bullying. Family Relationship Difficulties: Might include struggles in relationships with family members such as parents or siblings. Parenting Challenges: Could involve difficulties in setting consistent rules, frequent arguments, and power struggles. School/Work Troubles: Challenges may include falling behind academically, issues with teachers or peers, and conflicts at work. Substance Abuse: Might involve the use of tobacco, alcohol, or drugs. Body Image or Eating Issues: Concerns might include being overly concerned about weight or constantly dieting. Sleeping Problems: Possible troubles include difficulty falling or staying asleep and night-time worries. Gender Identity Concerns: May involve questions or uncertainties about one’s gender identity. Have your child (or you if the client) ever: * Required Endorsed suicidal thoughts? Engaged in self-harming behaviour? Been taken to the ER or been hospitalized due to mental health concerns? None of the above Is there any other information that you would like to share that may help us better support the client? Please indicate below: Submit Thanks for submitting! Thank you for completing this form. We will review your information and contact you as soon as possible. Please note that due to the high demand for services, there may be a delay in our response. Service availability depends on clinician availability and client needs. Should you have any questions in the meantime, please don’t hesitate to contact us at contact@beaconpsychology.ca . Warm regards, Beacon Psychology Team Want to know how we protect your data? Click here to learn more.

Helpful resources for children, youth, young adults, parents and educators on OCD. OCD and Related Disorders Resources Psycho-education about OCD Anxiety Canada provides evidence-based information and resources about OCD. The International OCD Foundation has outstanding resources about OCD, including fact sheets, videos, training and much more. The American Academy of Child and Adolescent Psychiatry also has excellent resources. The Peace of Mind organization offers free webinars about OCD for families, mental health professionals, and educators. Online resources for children and youth with OCD This animation provides psycho-education about OCD to children and youth. Another animation on OCD Helpful and simple descriptions about OCD for families Unstuck is a short movie about OCD from children’s perspectives. This link contains websites & books on OCD for children and youth. My ANXIETY plan is an online resource where children and youth can develop a plan to fight their OCD. OCD cartoons #OCD: Starving The Monster | Tauscha Johanson | TEDxIdahoFalls - YouTube Treatment for Children with OCD - YouTube How to Treat Anxiety with Exposure and Response Prevention - YouTube GoHackify! Kick Childhood OCD to the Curb (Animated Treatment Program) - YouTube What is OCD? Explaining Child OCD to Kids - YouTube The OCD Mind and Uncertainty | ACT - YouTube Katie d'Ath, OCD treatment specialist: Introduction - YouTube video Online resources for young adults and families This is a CBC radio show that discusses the experiences of people with OCD, including the host's own struggle with OCD. NHL's former hockey player Corey Hirsch's breathtaking report on his experience with OCD and depression. Educational Video Gallery for Understanding OCD Causes and Treatments (beyondocd.org) This video provides a look into former NHL player Corey Hirsch's fear of what his colleagues and coaches would think about his struggles with mental illness. Information about Moral Scrupulosity OCD OCD in schools This handout, developed by Dr. Juliana, describes how OCD is related to schooling and provides suggestions on how to address concerns related to OCD symptoms in school settings. This website provides suggestions for educators to develop Individual Education Plans (IEPs) goals and accommodations for students with different anxiety and/or OCD symptoms. In this podcast , Dr. Juliana talks about school accommodations for students with anxiety and OCD Other websites for resources and learning Dr. Aureen Wagner's anxiety & OCD quick guide videos Obsessive Compulsive Disorder (OCD) - Mental Health Literacy (mentalhealthliteracy.org) Online OCD Treatment & Therapy | OCD Counseling Help & Support by Licensed OCD Therapists (treatmyocd.com) OCD Online Treatment Online OCD Camp (check for dates on the IOCDF website): a virtual event for kids (6-17 years) and teens with OCD and their families sponsored by IOCDF! Beacon Selected OCD Books Books for Children & Teens OCDaniel by King Everything Is an Emergency: An OCD Story in Words & Pictures by Katzenstein Being Me with OCD: How I Learned to Obsess Less and Live My Life by Dotson Workbooks for Children & Teens Stuff That's Loud: A Teen's Guide To Unspiraling When OCD Gets Noisy by Sedley & Coyne Daring to Challenge OCD: Overcome Your Fear of Treatment and Take Control of Your Life Using Exposure and Response Prevention by Davidson & Bell, The OCD Workbook: Your Guide to Breaking Free from Obsessive-Compulsive Disorder by Hyman & Pedrick The ACT workbook for OCD by Mazz & Coyne Talking Back to OCD: The Program That Helps Kids and Teens Say "No Way" -- and Parents Say "Way to Go" by March & Benton The ACT Workbook for Teens with OCD: Unhook Yourself and Live Life to the Full by Zurita Ona, Ralph, & Gardner The Mindfulness Workbook for OCD; A guide for overcoming obsessions and compulsions using mindfulness and cognitive behavioral therapy by Hershfield & Corboy Parenting Books What to do when your Child has Obsessive-Compulsive Disorder: Strategies and Solutions: by Wagner Breaking Free of Child Anxiety and OCD: A Scientifically Proven Program for Parents by Lebowitz Misophonia Educational video on Misophonia Book about Misophonia PANDAS/PANS Understanding PANDAS/PANS for families Guidelines for Medical Doctors to assess PANDAS/PANS PANDAS/PANS school resources Webinars on PANDAS/PANS