How are you feeling currently?
Stressed Anxious Depressed Overwhelmed Content
Have you sought therapy before?
Yes No Not sure
How would you prefer therapy sessions?
In-person Online Phone Not sure
What time of day works best for therapy?
Morning Afternoon Evening Flexible Anytime
How do you prefer to pay for therapy?
Insurance Out-of-pocket Employer-covered Not sure
All set, how can we reach you?
Name
Email
Phone
(Details here)
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