Whats your occupation? *

Who referred you?

What specific issue would you like us to focus on during the session? *

What is your goal with this session? *

What do you think is the biggest obstacle holding you back from resolving this issue? *

Lack of time/finances to focus on this issue

Uncertainty about what steps to take

Have you sought help for this issue before? If yes, what approaches have you tried? *

Yes, individual/group therapy

No, I haven't sought help before

What is your IG username/ Tiktok username?

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