Connect With Us New Client Inquiry Form First Name Last Name Email Phone Number May we leave a voicemail at this number? -None- Yes No Tell us a bit about why you are reaching out This could include type of therapy, program, practitioner, or current challenges What is your availability? If applicable, check all that apply Daytimes Evenings Weekends Flexible What is your preference for location? If applicable, check all that apply In Person at Fairfield Psychology Location In Person at Oak Bay Psychology location Online sessions Any location How did you hear about us? -None- Online search (ie. Google) Referral from another practitioner Our sign/location Social Media Word of Mouth Online Directory (ie. Psychology Today) Other I consent to Fairfield Psychology/Oak Bay Psychology contacting me about their practitioners and scheduling a session. Please accept Privacy Policy Ready to book an appointment? Book Online Have a few questions? Book a Free Consultation Connect With UsPhone: 250-507-8363Email: contact@fairfieldpsychology.comFairfield Location: 1702 Lillian Road, Victoria, BCOak Bay Location: #202, 2186 Oak Bay Avenue, Victoria, BC
