Booking Go backAppointment Submitted Thank you for booking an appointment with me! Your booking will be replied to within 24 hours. Booking Form For counselling inquiries, please complete the form below and you will receive a response within 24 hours. Please be assured that all information sent to Couples On The Road is kept confidentially. Your details will only be kept if you become an actual client. Your privacy will be protected to the full extent of the law and professional ethics. First Name(required) Warning Last Name(required) Warning Email(required) Warning Phone(required) Warning Do you currently reside in BC?(required) Yes No Warning What are you interested in booking?(required) 15-Min Free Phone Consultation Individual Counselling Session Couples Counselling Session Relationship Check-In Package (4 sessions) Premarital Education Package (4 sessions) Warning Days and time preferred(required) Warning Do you prefer to meet in-person or online? *Not applicable for 15-min phone consultation (required) Online In person Warning Reasons for counselling:(required) Warning How did you hear about us? Friends/Word-of-mouth BCACC Website Psychology Today Website Wedding Shows Church Business Card Google Other Warning Warning. Send RequestSubmitting form Δ