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What is the reason for seeking care?

Select all that apply:

Anxiety or panic like symptoms. Attention difficulties, such as trouble focusing or listening. Behavioral issues, such as porn, video, or online addictions. Depression: feeling "blah," not interested in usual activities. Grief or Loss issues: a recent death or break-up with a partner. Relationship issues, such as with my partner or with people at work. Substance use: too much alcohol, marijuana, nicotine or caffeine. Trauma: recently witnessed or were involved in a traumatic experience. Work Related: underemployment, unemployment, too much stress. Divorce or Separation: anticipation or recovery. Men's Issues: low self esteem, only express anger, poor communication. Career Decision: return to school? switch jobs or companies? retire? Automatic or Intrusive Thoughts: "I'm not good enough," etc. Other: I want to speak to the counselor about this.

What ongoing or previous mental health concerns or treatment are/have occurred?

Select at least one and all that apply:

Individual counseling for me.

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