Informed Consent

About Your Therapist

I am a Registered Psychotherapist in Ontario and a member in good standing with the College of Registered Psychotherapists of Ontario (CRPO), registration number 004481. I hold a Master of Arts in Counselling Psychology from Yorkville University and have been registered with the CRPO since 2015. I am also a member of the Ontario Association of Mental Health Professionals (OAMHP).

As the Founder and Clinical Director of Ontario Therapy, I have over a decade of clinical experience across hospital-based rehabilitation and private practice. Prior to founding this practice, I worked at Altum Health through the University Health Network (UHN), one of Canada's leading hospital rehabilitation programs, where I worked alongside multidisciplinary teams supporting complex presentations including chronic pain, mild traumatic brain injury (mTBI), Complex Regional Pain Syndrome (CRPS), and Functional Neurological Disorder (FND). I have also provided clinical supervision to qualifying psychotherapists and facilitated psychoeducational workshops and mental health treatment groups.

My clinical specializations include complex trauma and cPTSD, pain reprocessing and the physical symptoms of nervous system dysregulation, and neurodiversity-affirming care. I hold an Advanced certification in Pain Reprocessing Therapy (PRT) — one of a small number of Advanced PRT practitioners in Ontario — and advanced training in Dialectical Behaviour Therapy (DBT). My integrative approach draws on somatic and polyvagal-informed practice, psychodynamic and relational therapy, and trauma-focused treatment modalities.

My practice is trauma-informed, neurodivergence-affirming, and LGBTQ+ affirming. I am myself neurodivergent, and this informs both how I work and the populations I am specifically equipped to support. Therapy here is a shared process: your perspectives, strengths, feedback, and lived experience are central to our work together — not incidental to it.

When working with pain-related concerns, therapy focuses on the psychological, emotional, and nervous system contributors to pain experience and does not replace medical assessment, diagnosis, or treatment. Clients are encouraged to maintain appropriate medical care and interdisciplinary support as needed.

Nature and Purpose of Psychotherapy

Psychotherapy is a collaborative, professional relationship intended to support emotional wellbeing, self-understanding, and meaningful change. Therapy may involve discussing difficult emotions, memories, bodily sensations, thoughts, or relationship patterns.

The goals, focus, and duration of therapy are individualized and will be discussed and reviewed over time. Therapy is not a substitute for medical care, legal advice, or crisis services, and outcomes cannot be guaranteed.

Professional and Ethical Boundaries

Registered Psychotherapists in Ontario are governed by the College of Registered Psychotherapists of Ontario (CRPO) and are bound by Standards of Professional Practice that include strict requirements regarding professional boundaries.

These standards prohibit:

• Dual relationships (e.g., personal, business, romantic, or financial relationships with clients or former clients)
• Sexual misconduct in any form
• Exploitation of the therapeutic relationship for personal benefit

If you have concerns about professional conduct, you may contact the CRPO at www.crpo.ca · 416-479-4330.

Potential Benefits and Risks of Psychotherapy

There are both potential benefits and potential risks associated with psychotherapy.

Participation in therapy is voluntary, and you are encouraged to discuss any concerns, reactions, or questions as they arise.

Confidentiality and Its Limits

All information shared in psychotherapy sessions is confidential and will not be disclosed without your written consent, except where disclosure is required or permitted by law.

Limits to confidentiality include, but are not limited to:

Risk of Serious Harm

If there is reasonable concern that you pose a serious risk of harm to yourself or others, I am legally required to take steps to protect safety, which may include contacting emergency services, notifying an identified person at risk, or involving other appropriate supports.

Abuse or Neglect of a Child or Vulnerable Person

If there is reasonable suspicion of current or past abuse or neglect of a child or vulnerable person, I am required to report this information to the appropriate child protection or legal authorities.

Court Orders or Legal Requirements

If records are subpoenaed or disclosure is otherwise required by law, relevant information may be released.

Insurance and Third-Party Payers

If you choose to use insurance or third-party funding, limited information such as diagnosis, dates of service, or receipts may be shared as required for reimbursement.

Professional Consultation and Supervision

As a Registered Psychotherapist, I engage in regular professional supervision and peer consultation to support ethical, safe, and effective care. Case information may be discussed in general terms with a qualified supervisor or consulting professional, who is also bound by professional confidentiality obligations. Your identifying information is not shared during these consultations unless directly necessary for safety or clinical reasons, in which case you would be informed.

Abuse by a Regulated Health Professional

If you disclose harm caused by a regulated health professional, I may be required to report this to the appropriate regulatory college.

Records and Access to Information

Clinical records are maintained in accordance with CRPO standards and privacy legislation (PHIPA). You may request access to your record, subject to legal and ethical limitations.

For clients who are minors, parents or legal guardians may have a right to access records, unless doing so would pose a risk to the client or is otherwise restricted by law.

Fees, Billing, and Cancellation Policy

Session Fees — effective August 1, 2026

Direct Billing

Ontario Therapy offers direct billing to most major Extended Health Benefit (EHB) insurance providers. If you have EHB coverage, your session fee may be billed directly to your insurer, reducing or eliminating out-of-pocket cost at the time of service. Registered Psychotherapy is not covered by OHIP but is covered under most private and employer-sponsored benefit plans. Please confirm your coverage with your provider and inform us prior to your session if you wish to use direct billing.

Sliding Scale and Reduced Fee Arrangements

If your current arrangement with Ontario Therapy differs from the standard rates listed above, this will be discussed and confirmed in writing. If you have questions about fees or accessibility, please reach out.

Payment is due at the time of service unless otherwise arranged in advance. Outstanding balances may need to be settled prior to subsequent sessions. Fees are reviewed periodically; you will be notified in writing prior to any future changes.

Cancellation & Missed Appointment Policy

Your appointment time is reserved specifically for you. Providing notice when you need to cancel or make changes helps support consistent care for all clients and allows appointment times to be offered to others when possible.

Appointments cancelled, rescheduled, or shortened with less than 24 hours' notice are considered late cancellations. The following policy applies within a rolling 12-month period:

Session add-ons booked at the time of scheduling are included in the total booked session fee.

Whenever possible, clients are encouraged to switch to a virtual session rather than cancelling entirely.

We understand that life happens — including illness, childcare challenges, emergencies, and unexpected circumstances. If something arises, please reach out as soon as possible. Exceptions may be made at clinician discretion where appropriate.

Repeated late cancellations, frequent last-minute rescheduling, or ongoing attendance concerns may be reviewed collaboratively and may result in the full session fee being charged at clinician discretion.

Contacting Your Therapist & Emergency Support

You may contact Ontario Therapy by email at info@ontariotherapy.org or by phone/text at (647) 855-0530. Messages are typically returned within two business days.

Between Sessions: Your therapist is not available for crisis support between scheduled appointments and cannot guarantee a response to after-hours messages. If you are in distress between sessions, please use the crisis resources listed below. You are encouraged to create a personal safety plan with your therapist if this is a concern.

Electronic Communication

Telehealth Services

Psychotherapy services may be provided in person, by secure video, or by phone. Participation in telehealth services is voluntary. Either you or your therapist may determine that telehealth is not clinically appropriate and discuss alternative options.

Telehealth services are provided using Jane App, a PIPEDA-compliant practice management platform used by regulated health professionals in Canada. Reasonable safeguards are used to protect privacy and confidentiality; however, absolute security cannot be guaranteed due to the nature of electronic communication.

Additional considerations for telehealth:

• You are responsible for choosing a private, safe, and interruption-free environment
• Technology disruptions or misunderstandings may occur
• Certain therapeutic interventions may not be appropriate for telehealth
• Sessions will not be recorded without explicit written consent from both client and therapist
• In the event of an emergency, local emergency services or your emergency contact may be notified

Email and Phone/Text Communication

For administrative communications (appointment confirmations, receipts, brief scheduling messages), Ontario Therapy may use email or phone/text in addition to Jane App's secure messaging.

Standard email and SMS/text messaging are not fully encrypted and carry inherent privacy risks. While Ontario Therapy uses reasonable safeguards, absolute security cannot be guaranteed outside of Jane App's secure platform.

By providing your email address and/or phone number, you consent to receiving administrative communications via these channels. Clinical or sensitive content will not be communicated through unsecured channels without your explicit request.

Social Media Policy

Ontario Therapy maintains a public online presence (@OntarioTherapy) for educational content, advocacy, humour, and community engagement. To protect privacy and therapeutic boundaries:

• We do not follow, like, comment on, or engage with clients on social media
• We do not acknowledge current or former clients publicly without explicit written consent
• Social media is not used for therapeutic communication and is not monitored regularly
• You are welcome to share or engage with public content; however, confidentiality cannot be controlled if you choose to comment or interact publicly
• Reviews and referrals are welcomed. Client status will never be acknowledged publicly unless authorized in writing

If you have questions or concerns about the services you receive, you are encouraged to discuss them directly with your therapist. If concerns cannot be resolved, you may contact the CRPO at www.crpo.ca · 416-479-4330 · 1-844-712-1369.

Consent to Treatment

By signing this document, you acknowledge that:

• You have read and understood the information outlined above
• Your questions have been answered to your satisfaction
• You understand the nature, benefits, and risks of psychotherapy
• You understand the limits of confidentiality
• You consent to participate in psychotherapy services with Ontario Therapy

You understand that consent may be withdrawn at any time by notifying your therapist.

Complaints Process

If you have concerns about the services you receive that cannot be resolved directly with your therapist, you may contact the College of Registered Psychotherapists of Ontario (CRPO):