Fill out the short questionnaire so that we can hit the ground running on your call. ⬇️

Fill out the short questionnaire so that we can

hit the ground running on your call. ⬇️

What is your gender?

Man

Woman

Other

Prefer not to say

How old are you?

How old are you?

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No elements found. Consider changing the search query.
List is empty.

What led you to consider therapy today?

(Please go beyond saying "depressed" or "anxious" - share how this is impacting you on a day to day basis)

*

What are some of the things you are struggling with?

I've been feeling depressed

I feel anxious or overwhelmed

I always feel stressed

I am constantly worrying

I feel burned out

How I feel is affecting my relationships

I have experienced trauma, and think it is still impacting me

I am becoming more angry and irritable as of late

How long have you ben experiencing these struggles?

0-3 months

3-6 months

1-2 years

2+ years

Have you been in therapy before?

Yes

No

Which state are you in?

Washington

Not in Washington, and I will leave this page immediately

You have completed the questionnaire!

Let's get you scheduled for a complementary 15-minute consultation.

First Name *

Last Name *

Phone *

Email *

I agree to the Privacy Policy and Terms & Conditions provided by the company. By providing my phone number, I agree to receive sms messages from the business to schedule a free consultation.

NEXT

What is your gender?

Man

Woman

Other

Prefer not to say

How old are you?

How old are you?

18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
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86
87
88
89
90
91
92
93
94
95
96
97
98
99
No elements found. Consider changing the search query.
List is empty.

What led you to consider therapy today?

(Please go beyond saying "depressed" or "anxious" - share how this is impacting you on a day to day basis)

*

What are some of the things you are struggling with?

I've been feeling depressed

I feel anxious or overwhelmed

I always feel stressed

I am constantly worrying

I feel burned out

How I feel is affecting my relationships

I have experienced trauma, and think it is still impacting me

I am becoming more angry and irritable as of late

How long have you ben experiencing these struggles?

0-3 months

3-6 months

1-2 years

2+ years

Have you been in therapy before?

Yes

No

Which state are you in?

Washington

Not in Washington, and I will leave this page immediately

You have completed the questionnaire!

Let's get you scheduled for a complementary 20-minute consultation.

First Name *

Last Name *

Phone *

Email *

I agree to the Privacy Policy and Terms & Conditions provided by the company. By providing my phone number, I agree to receive sms messages from the business to schedule a free consultation.

NEXT

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