Create Wellness Counseling LLC
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Reason for care
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Appointment info
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Prescreener
Reason for care
3
Contact information
What is the reason for seeking care?
Anxiety
ADHD
Depression
Grief
Relationship issues
Substance use
Trauma
Other
Have you ever received mental health support before?
Select all that apply
I’m currently in therapy
I’ve been in therapy in the past
I currently have a medication prescriber (psychiatrist, PCP, etc.)
I’ve taken mental health medication in the past
I’ve participated in a higher level of care (IOP, PHP, or inpatient)
None of these apply
If you or others are in immediate danger or experiencing a medical emergency, call 911 immediately.
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