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What is the reason for seeking care?

What mental health struggles are you currently experiencing?

Anxiety Attentional difficulties Behavioral issues Depression Grief Relationship issues Substance use Trauma Other

What kind of care is being sought?

Individual Therapy Family Therapy Couples Therapy I am not sure

What mental health treatment have you received (check all that apply)?

In therapy now In therapy in the past Taking psychiatric medication now Took psychiatric medication in the past Hospitalized for mental health within the past 6 months Hospitalized for mental health reasons over 6 months ago History of suicide attempts None of these apply

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