Thank you for your interest to be a client of Stephane & Clinique PsySanté.

At Clinique PsySanté, all our practitioners are highly skilled and work with a customized intervention plan for you. To best serve you, we invite you fill out an assessment questionnaire. Please complete the appointment request form below to make your initial appointment request. After receiving your information, we will send you an email with the link to your assessment questionnaire. Once you fill out your Assessment Questionnaire to your best capacity and click on the “Submit” button, please send us an email at info@psysante.com to inform us. Then, your information will be carefully reviewed  and then you will be contacted by email or phone to set up your initial assessment appointment. Please allow us 2-4 business days to review your file and contact you. We look forward to connecting with you!    Please note that all your information will remain strictly confidential. 

Appointment Request Form

Name:  
Email:  
Phone:  
Age:     
Gender:

Type of service you wish to consult for:

Description of your current situation: