First Step To Psychotherapy Form

Please fill in the form below, providing as much relevant information as possible, and sent it back to me prior to your initial assessment session

Name

First Name

Last Name

What specific difficulties or challenges are you experiencing that you would like to address in psychotherapy? .

Please provide details about your current challenges and how they are affecting your life.

Are there any specific situations or events that have recently contributed to your decision to seek psychotherapy?

How would you describe your current emotional state and overall well-being?

How did you hear about our therapy services?

What would you like to achieve in psychotherapy?

Have you had any previous experience with therapy, counseling or any other mental health intervention?

if yes. please provide details below

Please feel free to provide any additional information that you would like me to know

first step to psychotherapy form