Crowdsourced Therapist Database
Hello!

If you have been eager to recommend your therapist because they've done a fabulous job in helping you gain perspective with respect to the challenges you are/were facing, then this form is for you :) 

I'm Mallika, the founder of Unloop Wellness. I'm building India's comprehensive, active database of mental health professionals on Unloop. 

This is an initiative that blossomed from my personal quest in search of  the 'right therapist' who could provide the emotional stability and support I so desperately needed. I've walked that winding path, experienced the trials and errors firsthand, and understand the emotional and financial toll it can take on a person who is already not in a good place. 

There are 10-12 short questions and that should take you about 3-5 minutes!

Let's get started! :)

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Name of the therapist *
Approx age of the therapist *
City they are based out of *
Therapist's contact details (please check with them if they are comfortable with you recommending them) *
Gender of the therapist *
Therapy was for
You can check multiple boxes
 *
Required
Approx age of the person who sought their services *
Mode of therapy 
You can check multiple boxes
 *
Required
For how long have they been seeing the therapist? *
Fee per session (INR) *
Required
Challenges they've addressed 
You can check multiple boxes
This space is for a line or two that you would like to write about the therapist you are recommending (optional)
Any apprehensions, thoughts, suggestions, insights or questions are most welcome :)
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