Request appointment | Time of Need Counseling, LLC

What is the reason for seeking care?

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

What mental health concerns or treatment have occurred in the past?

In therapy now In therapy in the past Taking psychiatric medication now Taken psychiatric medication in the past Hospitalized for mental health reasons now or recently Hospitalized for mental health reasons in the past Known neurologic or genetic disorder Attempted suicide in the past None of these apply

Are you currently having suicidal thoughts or thoughts of harming others?

If you answered yes to this question, online therapy is not recommended. Do not continue request form.

Yes No

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