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Answer the questions below to get matched with your primary counsellor.

Get started by answering the questions below to get matched with a primary counsellor.

Our team will review your submission and connect you with a counsellor that will walk with you as you curiously climb your summits within.

Individuals Start Here

What brings you to counseling today?

I am struggling with interpersonal conflict, boundary setting, or communication in my relationships

I feel emotionally overwhelmed, or I'd like to explore my emotions more deeply and find tools to help me regulate more effectively

I feel a sense of distance or disconnect — from myself, from others, or both

I feel stuck, lost in my purpose, or like I'm standing at a crossroads and not sure which way to turn

I feel things that are hard to put into words — tension, stress, or a heaviness I carry in my body

I'm not sure yet — I just know I need some support right now

Select all that apply

When life feels hard or overwhelming, how do you tend to respond?

My mind takes over — I replay situations, overthink, and find it hard to switch off

My emotions feel big and hard to contain, like they spill out before I can catch them

I go quiet and pull away — from others, and sometimes from myself

I feel it in my body first — tension, heat, a racing heart, or a feeling I can't quite name

I keep moving and stay busy — if I stop, I might have to feel it

Other

This helps us understand how you experience stress so we can tailor our approach to you. Select all that apply.

Which of the following resonates with what you're navigating right now?

Choose one or more options

These are the areas our counsellors specialise in. Select as many as feel relevant — there's no limit.

What are you hoping to take away from counseling?

Choose one or more options

Select all that apply — this helps us understand what success looks like for you.

When it comes to how you like to work, I am looking for a counsellor who helps me:

Talk things through out loud — processing my thoughts and feelings as they come

See patterns, connect the dots, and make meaning of my experiences

Explore and process the past and how it has shaped who I am today

Focus on the future — setting goals, building a vision, and figuring out how to get there

Gently challenge my beliefs and the stories I tell myself

Proactively check in, offer reflections, and guide the conversation with intention

Expand my toolkit with practical strategies, resources, and new ways of thinking

Give me homework — I like to do work between sessions and keep the momentum going

Other

Select all that apply — this helps us find the right fit for you.

Anything you would like to share?

Full Name

Date of birth

Email *

Phone *

By checking this box, I consent to receive non-marketing text messages from Summit Within Therapy Collective about booking discovery calls or upcoming sessions.

I prefer booking the discovery call over text, rather than email.

City

NEXT

Couples Start Here

What brings you to counseling today?

We are struggling to connect with one another

We are struggling to understand one another

Our values, priorities, core-beliefs, etc. feel out of line

We are dealing with a major life transition (having a child, career changes, moves, etc.)

We are struggling as a couple due to other demands we are experiencing (extended family, work, health, etc.)

We keep stumbling over the same conflict over and over

We want to build and grow together

Select all that apply

What do you and your partner hope to get out of counselling?

Choose one or more options

Select all that apply

What are you and your partner's expectations from your counsellor?

Choose one or more options

Select all that apply

Are you both comfortable with being assigned homework to do between sessions?

Yes

No

I don't know (or, it depends on the week!)

Anything you would like to share?

Your Full Name

Your Partner's Full Name

Main Contact Email *

Main Contact Phone

By checking this box, I consent to receive non-marketing text messages or calls from Summit Within Therapy Collective about upcoming sessions.

I prefer texts or calls over emails when booking the discovery call.

City

NEXT

A note for couples: If possible, we encourage couples to sit down together and fill out the survey below. This survey consists of four short questions that help guide our team in the matching process. It is best if both couple's are represented in the submission.

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