Street Therapy

Psychotherapy, Assessments & 

Counselling

Client Forms


Your therapist will send you the forms or questionnaires you need to complete. 


Session 

Evaluation Form


End of Treatment

Feedback Form


Telehealth Consent Form



Collaborative Care


Street Therapy believes in collaborative care and understands that mental health treatment shouldn't be done in isolation. Mental health affects our overall well-being, as much as physical health. If you would like a third-party professional or clinician (e.g., treating physician, specialist, school, a local agency, spiritual leader, caseworker, etc.) to share documentation on your behalf, please fill out a personal health information disclosure form and 

ask them to send all confidential and important documentation to our fax number, 


1-888-510-2079

Document Submission Link

Click the inbox icon above to submit forms assigned to you by your therapist. It directs you to the password-protected file submission page.


Please ask the therapist for your password. Please be reminded that you will need to submit your forms within the time period given by your therapist. Your password will only work for a certain period of time.   


Thank you. 

Client Feedback


If you would like to leave some comments regarding the services that our Street Therapists provide, please use the forms below and hit the submit button to send them in. Thank you! 

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Address

177 Victoria Street North, Suite 101

Kitchener, Ontario N2H 5C5


429 Queen Street South, Suite 204

Kitchener, Ontario N2G 1W6


Contact


Local +1 (226) 887-6320

Phone +1 (888) 977-5820

Fax +1 (888) 510-2079

[email protected]


Hours

By Appointment Only. 


Mon-Fri: 9:00 am - 5:30 pm (EST)

Sat: 9:00 am - 1:00 pm (EST)
Sun: Closed


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