What has been your biggest emotional challenge since immigrating?
Loneliness Anxiety Loss of identity or purpose Low self-esteem Other: _________
Have you ever done therapy or received emotional support before?
Yes, I’m currently in therapy I’ve done it in the past, but not anymore No, never
If there were an accessible and welcoming space specifically for Brazilian immigrants, would you be interested in joining?
Yes Maybe No
Is there anything else you’d like to share with me?
Open text box
All set, how can we reach you?
Name
Email
Phone
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    Empowering Immigrant Mental Health

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    Supporting Your Emotional Journey

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    Your Voice Matters in Mental Health

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