Fill out the short questionnaire to help us hit the ground running on our call ⬇️

Fill out the short questionnaire to help us

hit the ground running on our call ⬇️

What is your gender?

Man

Woman

Other

Prefer not to say

How old are you?

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?

California

Not in California, 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.

Privacy Policy - Terms of Service