Please tell us a bit about yourself...
What is your gender?
How old are you?
What language do you speak? (Choose all that apply)
What type of service are you looking for?
Are you struggling with persistent sadness or low mood?
Are you struggling with anxiety, worry or difficulty managing stress?
Are you seeking help dealing with abuse or trauma?
Are you seeking help for relationship problems?
Are you seeking help for a question we haven't asked about?
Please indicate the issue(s) you are seeking help with?
Would you prefer to work with a man or a woman?
Would you prefer to to see a clinician with a specific religious background?
What religious background(s) would you prefer?
Does sexual orientation matter?
Would you prefer to see a gay or straight clinician?
Do you have a preference in the theoretical approach used by your therapist?
Which theoretical approach would you prefer?
You have completed the questionnaire
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