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Getting started with therapy
We understand it's not alway easy to begin your therapy journey. Let us make it simple for you. You just need to take the first step, and show up, the rest we'll take care of!
Please fill this form so we can understand what you are seeking from therapy and align you with the most suitable therapist/counsellor according to your needs. You can write as much, or as little, whatever you may be comfortable with. The form is confidential, and your details will only be shared with your therapist.
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Email
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Your email
Name you want to be addressed as
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Your answer
Languages in which you are most comfortable
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Your answer
City/Country
Your answer
Date of birth
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Your answer
Gender pronoun preference(They/Them; She/Her; He/Him)
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Your answer
Contact info (Phone number for text/whatsapp)
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Your answer
Profession
Your answer
Relationship status
Your answer
Do you have any Physical Health Conditions (for example, asthma, high or low blood pressure, heart disease, diabetes, Cancer, HIV, epilepsy, allergies, chronic illnesses, etc.) or any disabilities?
Your answer
Have you ever had any form of counselling or psychotherapy before? If so when and for how long and in what context?
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Your answer
Could you give a short description of the issues that are bringing you to psychotherapy now? Please feel free to write as much or as little as you would like.
Your answer
What would you like to achieve from therapy?
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Your answer
Send me a copy of my responses.
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