Referral Form

CBT Niagara is a private, fee-for-service psychological clinic offering individual cognitive behaviour therapy. Our services are not covered by OHIP although psychological services are often covered through extended health care plans.


Please note: We do not accept any referrals which are MVA related. Also, our therapists provide services to patients ages 14+ years old.

May we leave you a voice message?

Symptoms You're Experiencing

Referral Information

Do you have extended health insurance?
Type of therapist covered under insurance:
Are you a veteran?
Are you a first responder?
Are you currently off work due to your mental health?
If yes, occupation?

Please check your 'junk mail' for our email response!

Thanks for submitting!