Let's get started

Welcome! We're glad you're here. Let's go through some questions to get you set up.

First name *

Last name *

Please provide your legal first and last name for verification purposes.

Email address *

Phone number *

Demographics

Who you are and where you're from matter. Our goal is to match you with a provider who gets you - all of you.

State of residence *

Date of birth *

Ethnic Identity *

Gender Identity *

Sexual Orientation *

Generational Status *

Why are you seeking care?

Every journey is unique. We'd love for you to share your story in your own words in detail, so we can match you with the right provider.

(1000 characters left)

Have you tried therapy or other mental health services before?

Yes No

What can we help you with?

Please select up to 3 areas of concern, so we can tailor your care to address your key needs.

Select up to 3

• Academic-related stress
• Alcohol or other substance issues
• Anger management
• Anxiety
• Culturally-responsive treatments
• Depression
• Ethnic and racial identity related issues
• General mood issues
• Grief/loss
• Impulse control difficulties
• Intergenerational trauma
• Interpersonal problems
• LGBTQ+ related concerns
• Low self-esteem
• Major life transitions
• Maternal mental health issues
• Panic attacks
• Parenting-related issues
• Relationship difficulties
• Sexual concerns
• Sleep problems
• Social fears
• Trauma-related stress
• Work-related stress
• Worry
• Other

A few clinical questions

The below questions ask about some difficult topics. We ask every client to ensure safety and to understand the support you may need.

If you are in a crisis, please call 911 or go to your nearest hospital's emergency room.

1. Over the last two weeks, how often have you been bothered by the following problems?

   • Feeling nervous, anxious or on edge
     • Not at all Several days More than half the days Nearly every day
   • Not being able to stop or control worrying
     • Not at all Several days More than half the days Nearly every day
   • Feeling down, depressed or hopeless
     • Not at all Several days More than half the days Nearly every day
   • Little interest or pleasure in doing things
     • Not at all Several days More than half the days Nearly every day

2. I currently have thoughts about killing myself.

   • Yes No

3. I have previously acted on my suicidal thoughts by attempting to kill myself.

   • Yes No

4. I have previously heard voices no one else could hear and/or seen objects or things that others could not see.

   • Yes No

Therapist Preferences (optional)

Having the right therapist can be truly empowering. We’ll strive to meet your preferences, along with factors like capacity.

• Style of the therapist
• Gender of the therapist
• Ethnicity of the therapist

Additional questions

We collect this information to confirm eligibility. You will NOT be charged now.

How do you plan to pay for sessions? *

If you do not see your insurance carrier in the dropdown list above, we are not currently contracted with them but hope to be soon!

How did you hear about us? *

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