Online Appointment Request

To book OHPSA personal counselling, MD career counselling, learning skills appointment or MRS counselling appointment please fill out the form below.

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Your Name:

Program of Study:

Year of Study:

Your Email Address:

Enter a valid email address. Example: name@company.com

Your Phone Number:

Enter a valid phone number. Example: 123-456-7890

Please select the type of counselling you are requesting:

Personal Counselling

Career Counselling

Learning Skills Counselling

Are you a MAM student?

Yes

Have you visited with one of our counsellors in the past?

Yes

Name of the counsellor you visited previously (if applicable):

When are you available for an appointment? Please list blocks of available time (i.e. Monday afternoon, Friday 2-5, etc.)

Today's Date:

Faculty of Medicine