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?

How old are you?

What led you to consider psychiatric care 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.

NEXT

What is your gender?

Man

Woman

Other

Prefer not to say

How old are you?

How old are you?

What led you to consider psychiatric care 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.

NEXT

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