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Juvonno client portal sign up/login

To add yourself to our waiting list, please fill out the contact form below or visit our practice management client portal by clicking the icon above.

Get in Touch

If you are seeking couples/relational/family therapy, please have each person who will be attending therapy fill out the following form.

Name *

Legal name

The name we should put on receipts/use for insurance

Insurance info

If applicable

Pronouns *

Date of birth *

Email address *

Phone number *

Address *

Preferred language *

Type of therapy *

Location *

name Legal Location

Availability *

ie Monday mornings, Tuesday evenings, etc.

Presenting issues

Include a brief summary of your reason(s) for seeking therapy.

How did you hear about us?

Diverse Roots Therapy is located in Punamu’kwati’jk. We live and work on the unceded and ancestral land of the Mi’kmaq people.

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