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Booking Information:
Hey there!
Welcome to Therapy by Saniya! π»
We are so proud of you for taking this step!ππ» Β π We hope to help you in the best way possible!
Kindly fill this form to book a session with us. Please try and be as detailed as possible as this will help us in understanding if we have the best-fit therapist for you!
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Email
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Record my email address with my response
Date of filling this form?
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Your answer
Your Name?
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Your answer
Your Email Address ?
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Your answer
Your WhatsApp Number?
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Your answer
Your Location?
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Your answer
Your age?
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Your answer
What do you do?
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Student
Working professional
Home maker
Taken a break
Other:
How did you get to know about us?
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Instagram
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Someone referred
Which therapist would you like to go with?
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Ms. Saniya Bedi
Ms. Mansi Desai
In case someone referred, then please share the details of the person:
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Your answer
Please share your concerns.
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Your answer
What is your preferred day and time for the session? (Session Duration - 45 minutes)
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3:15 - 4:00 p.m. (Weekday - Dr Saniya)
4:45 - 5:30 p.m. (Weekday - Dr Saniya)
8:45 - 9:30 p.m. (Weekday - Dr Saniya)
9:45 - 10:30 a.m. (Weekend - Dr Saniya)
10:45 - 11:30 a.m. (Weekend - Dr Saniya)
10:15 - 11:00 a.m. (Weekday - Ms Mansi)
11:15 a.m. - 12:00 p.m. (Weekday - Ms Mansi)
12:15 - 1:00 p.m. (Weekday - Ms Mansi)
3:45 - 4:30 p.m. (Weekday - Ms Mansi)
Any 45 min slot between 10:30 - 5:00 p.m. (Weekday - Ms Mansi)
Other:
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What is your preferred mode of session?
Chat session
Audio session
Video session
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What according to you are some of your strengths?
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Your answer
Do you believe that therapy can be a safe space wherein you can not only share your concerns but also share anything that you feel like?
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Yes
No
I am not sure
In your opinion, how committed are you towards working on your concerns with me in therapy?
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1
2
3
4
5
6
7
8
9
10
I understand that appointments are fixed on first come first serve basis. This means that I may not get a slot immediately upon requesting for the same.
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I agree
*Disclaimer*
We do not offer crisis counselling services. In case you feel you or anyone you know may require immediate help, please reach out to your nearest hospital or a crisis counselling helpline.
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