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Therapy Intake Formuuu
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Please provide a way for us to reach you (phone or email). We primarily communicate via WhatsApp.
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Please provide a way for us to reach you (phone or email). We primarily communicate via WhatsApp.
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What type of therapist are you looking for?

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What brings you to therapy?
Briefly describe your concerns. What would you like to work on, resolve, or improve?
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Please provide your name, surname, or a nickname (e.g., "anonymous22") if you prefer to remain anonymous.
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Do you have any specific preferences regarding therapy? (e.g., budget, values, a specific therapist, or other important criteria)
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I consent to the processing of my personal data.


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