Intro Call Booking

My mission is to help you regain control, find balance, and thrive in your professional and personal life

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9:30 - 10:00 AM, Friday 8th November, 2024

Section 1: About You

First Name

Last Name

Email

Phone

Street

City

Post Code

Country

Date of Birth

Section 2: Current Situation

Briefly tell me about the issues you’d like to address in therapy

Have you seen a therapist before about this issue?

Have you been considering suicide?

Are you mandated by court to seek therapy?

Are you currently seeing a psychiatrist or taking any psychiatric medications?

Section 3: Past History

Have you any experience with Therapy before? Do you have any preferences?

Have you ever been diagnosed for a mental disorder?

Have you ever been hospitalized for mental health reasons?

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