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 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 down, sad, or hopeless.

I feel anxious, overwhelmed, or constantly on edge.

I often feel weighed down by stress or life’s challenges.

I have trouble concentrating or making decisions because of worry or low mood.

I feel emotionally drained or burnt out.

My struggles are affecting my relationships and sense of connection.

I’ve experienced trauma or significant life challenges and am seeking support to heal.

I’ve been feeling more irritable, frustrated, or disconnected lately.

I want to improve my emotional wellbeing and find hope and balance.

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?

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 down, sad, or hopeless.

I feel anxious, overwhelmed, or constantly on edge.

I often feel weighed down by stress or life’s challenges.

I have trouble concentrating or making decisions because of worry or low mood.

I feel emotionally drained or burnt out.

My struggles are affecting my relationships and sense of connection.

I’ve experienced trauma or significant life challenges and am seeking support to heal.

I’ve been feeling more irritable, frustrated, or disconnected lately.

I want to improve my emotional wellbeing and find hope and balance.

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

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