Get Started

Help us match you to the right therapist

Please fill out this short questionnaire to help us match you with the most suitable therapist for you, as well as give your therapist a good starting point in getting to know you.

What type of therapy are you looking for?

What is your gender?

What is your current relationship status?

What led you to consider therapy today?

Over the past two weeks, how often have you lost interest or satisfaction in things you once found pleasure in?

Over the past two weeks, have you experienced a decrease in energy or felt a significant increase in fatigue?

Over the past two weeks, how often have you not felt like yourself or that you are struggling to get things right in your life or felt that you’re a disappointment to yourself and/or your family?

Are you currently experiencing any intimacy issues?

Have you experienced any thoughts of suicide or had suicidal attempts/actions?

Are you currently experiencing chronic pain and/or medical conditions?

Are you taking any prescribed medication (s)?

Do you find yourself using alcohol, drugs or prescription medication to numb the pain or help you to forget what you’re going through?

Do you identify as being religious, spiritual, faith-based?

Which religion do you identify with?

How important is it for you to be matched with a therapist who has the same belief system as you do?

Do you want to incorporate your spiritual and/or religious beliefs into your therapy sessions?

Have you ever participated in mental health therapy before?

What brings you to Elevate today?

What do you want to accomplish in your therapy session?

What kind of physical shape are you in?

How would you describe your current eating habits?

If you stop and think about your current feelings, would you say that you are feeling stressed, anxious, sad or depressed?

Have you experienced any losses that’s been difficult to deal with?

If you stop and think, over the last two weeks, have you experienced increased irritability/aggravation, difficulty handling angry emotions, or reacting without thinking?

In the past two weeks, how often have you been affected by any of these issues:

Not finding things to do that brings you joy or happiness.

In the past two weeks, how often have you been affected by any of these issues:

Feeling like you’re dragging and can’t seem to find the energy or motivation to do anything?

On the flip side, feeling like you can’t seem to slow down- you are restless, constant shaking, constant moving in motion more than what is usual for you?

In the past two weeks, how often have you been affected by any of these issues:

Feeling like you can’t get pass the negative/bad experiences that have been holding you back from being the “Best me” you can be?

In the past two weeks, how often have you been affected by any of these issues:

Have you noticed any changes in your sleep pattern:

Have you experience any family conflict that causes disruptions in your life that you would like to work through?

In the past two weeks, how often have you been affected by any of these issues:

Trouble focusing on things like reading, watching T.V. shows that you used to enjoy, studying, work?

In the past two weeks, how often have you been affected by any of these issues:

Feelings/thoughts of hurting yourself, taking your life, just going to sleep and never waking up again?

In the past two weeks, how often have you been affected by any of these issues:

The problems that you’re having, how much have they affected your work/school, taking care of things at your place or getting along with others?

In the past two weeks, how often have you been affected by any of these issues:

Not sure how to handle my choices of gender identity and/or sexuality, how to reply to people when they ask me intimate questions about being transgender, feeling pressured to justify my sexuality decisions and/or not being able to keep my sexuality private.

In the past two weeks, how often have you been affected by this issue:

Disappointing my family and friends because I don’t practice or agree with the religion/spirituality that they want me to follow

Are you currently working now?

Are you a full-time/part-time student?

Experiencing new intimacy challenges?

How often do you drink alcohol within a month?

How often have you been affected by any of these issues?

Not being able to express your emotions without getting violent, hitting something/ someone, or destroying property.

How often have you been affected by any of these issues?

Trying to find the best way to handle the stress and negative situations in my life.

How often have you been affected by any of these issues?

Trying to find the balance of work, life, and family

Have you been not satisfied, stressed, worried, uncertain, regarding the stability of your job or career

Are you struggling with finances, living from paycheck to paycheck, not making ends meet, and wanting to save money but not knowing how to do it

Are you having moments where you can’t calm yourself down, feeling scared of things that you weren’t scared of before, and/or experiencing times when you can’t catch your breath?

If you were prescribed any medications for your mental health, are you taking them recommended?

congratulations