Pre-Consultation Questionnaire

Please complete the following questionnaire as accurately and honestly as possible. Your responses will help me better understand your needs and ensure you receive the appropriate support.

Questionnaire
  • Personal Information
  • General Mental Health Status
  • Symptoms & Concerns
  • Lifestyle & Social Factors
  • Substance Use & Risk Factors
  • Additional Information
  • Consent & Confidentiality
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Gender
What type of therapy are you interested in?