Individual Sign Up
Please use this form to sign up for free counseling sessions. We will match you with one of our licensed counselors and get in touch with you to proceed to next steps.
Email address *
Name (or nickname) *
Age *
In the last few weeks, have you had any changes to: *
Required
Is there anything else we should know?
Prefered language used for therapy *
Location/Time Zone (Beirut, Paris, Dubai, etc...) *
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