YOUR PATH TO CHANGE BEGIN NOW

Please provide thorough answers to help your assigned therapist understand your needs clearly and transparently.

This will enable them to offer you the best possible support

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What is your gender?
Are you
(Please list the languages you are comfortable with in therapy):
Have you ever been in therapy before?
(Describe any positive or negative aspects you would like us to consider when matching you with a therapist.)
(Please describe in your own words): (E.g., support with anxiety, guidance in relationships, help with stress management, etc.)
What type of therapy are you looking for?
(Please select all that apply):
(Please specify):
What are your primary concerns or issues you would like to address in therapy?
(Please select all that apply):
Please specify):
Do you have a preference for the therapist's gender?
How important is it for your therapist to have experience with your specific concerns?
Do you prefer your therapist to have experience working with certain populations?
(Please select all that apply)
Which session format would you prefer?
What days are you available for therapy sessions? (Please check all that apply):
Preferred time slots
(Please check all that apply):
Would you like a therapist who specializes in cultural sensitivity and competence?
(Please specify if applicable):
What are your expectations from your therapist? A therapist who...
Do you have any problems or worries about intimacy?
How often do you drink alcohol?
When did you most recently think about ending your life
Are you experiencing anxiety, panic attacks, or phobias at the moment?
Are you on any medication right now?
Are you facing any persistent pain right now?
How’s your financial situation currently?
How would you describe your sleeping habits right now?
What times are you available for therapy sessions?
Specify your preferred time slots for sessions.
How did you know us?
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