Take this 2-minute quiz
to get matched with a therapist
What is your gender identity?
*
Male
Female
Other
How old are you?
*
18-24
25-49
50-64
65 & Older
How do you identify?
*
Straight
Gay
Lesbian
Bi or Pan
Prefer not to say
What is your relationship status?
*
Single
In a relationship
Married
Divorced
Widowed
Other
Do you consider yourself to be a spiritual person?
*
Yes
No
Have you ever been in therapy before?
*
Yes
No
What led you to consider therapy today?
*
I've been feeling depressed
I feel anxious or overwhelmed
My mood is interfering with my job/school performance
I struggle with building or maintaining relationships
I can't find purpose and meaning in my life
I am grieving
I have experienced trauma
I need to talk through a specific challenge
I want to gain self confidence
I want to improve myself but I don’t know where to start
Recommended to me (friend, family, doctor)
Just exploring
Other
What are your expectations from your therapist? My therapist...
*
Listens
Explores my past
Teaches me new skills
Challenges my beliefs
Assigns me homework
Guides me to set goals
Proactively checks in with me
Other
I don't know
How would you rate your current physical health?
*
Good
Fair
Poor
How would you rate your current eating habits?
*
Good
Fair
Poor
Are you currently experiencing overwhelming sadness, grief, or depression?
*
Yes
No
Do you have any problems or worries about intimacy?
*
No
Yes
When was the last time you thought about suicide
*
Never
Over a year ago
Over 3 months ago
Over a month ago
Over 2 weeks ago
In the last 2 weeks
Are you currently experiencing anxiety or panic attacks?
*
Yes
No
