Therapy Waitlist Request

Emergency Assistance

Please note that my services are not intended for emergencies.

Canadian crisis line: Call or text 988 any time if somebody is in emotional crisis.
911: Call 911 or go to your nearest hospital's emergency room if somebody is going to hurt themselves or others.

Hello! Thanks so much for connecting with me on your journey of personal growth and healing.

To provide the best care possible for my existing and new clients, I have started a small waitlist for new therapy clients. Here is the process for starting therapy together:

Please complete this Therapy Waitlist Request form.
I'll email you to confirm your request and let you know if my services are likely a good fit for your needs.
When a space becomes available, I will reach out to each person, one at a time, in order of the list. I'll ask you to let me know within 24 hours if you'd like to take the space and get started together.

Estimated wait time: Currently 2 - 4 months. Please note that wait times are hard to predict. A space may become available sooner. If the wait time unfortunately becomes much longer, I will let you know.

Availability: I currently offer therapy on Monday mornings and early afternoons, in-person in Victoria or virtually from anywhere in BC.

When waiting for support is not recommended: I urge you to seek more immediate support from another professional if you are: dealing with highly stressful or traumatic events, suffering with severe distress, having immense difficulty functioning in daily life, or struggling with time-sensitive mental health concerns (e.g., mania, psychosis, suicidal thoughts, self-harm, severe depression, severe post-traumatic stress). The British Columbia Psychological Association is a great resource for finding a psychologist: https://psychologists.bc.ca/find-psychologist. If you're having trouble finding somebody, please reach out to me via this form and ask me to try to gather referrals for other professionals or resources for you. I'll do my best to help.

Your privacy is important to me. This secure form protects your personal and health information in accordance with privacy laws in British Columbia, Canada.

My Information

I am a parent or guardian seeking therapy for my youth (Please enter your youth's information here. You can enter your own information in the next section that appears).

First name

Last name

Preferred name

Pronouns

Date of birth

Email address

Are you OK with Kristen emailing the address above with information about your therapy waitlist request?

Yes

Parent(s) or Guardian(s) Information

First name

Last name

Pronouns

Relationship to the youth

Email address

Would you like Kristen to email the address above with information about your therapy waitlist request?

Yes

First name

Last name

Pronouns

Relationship to the youth

Email address

Would you like Kristen to email the address above with information about your therapy waitlist request?

Yes

Therapeutic Needs

Please briefly describe your reasons for seeking therapy for yourself or for youth. You may choose to share a bit about current struggles, as well as what type of support you're looking for.

Is there anything else you'd like to share with Kristen?

Do you have any questions for Kristen?

Therapy is currently offered on Mondays between 8:45 am and 2:00 pm. Please indicate your typical availability for appointments:

Please indicate your preference for in-person or virtual appointments

In-person

at 821 Burdett Ave

Virtual

via Jane App videoconferencing

Interested in either or both in-person & virtual appointments

Please note that completing this form does not initiate a psychologist-client relationship together. This type of relationship can be established during our initial therapy session.

Your information will be encrypted.

Therapy Waitlist Request

Emergency Assistance

My Information

Parent(s) or Guardian(s) Information

Therapeutic Needs

Emergency Assistance

Dr. Kristen Silveira

Registered Psychologist #2832