Vlad Munteanu Nothing you write here leaves your device and nothing is saved on this site. At the end, you choose: download it, print it, or send it by email from your own app.
1. About you
Only what I need to be able to contact you and, in an emergency, to let someone close to you know.
2. Your family and context
The people around you are part of the story. Write as much as you see fit; everything here is optional.
3. Your health
Some conditions and medications directly affect sleep, energy, and mood, so it helps to know about them.
4. Mental health
History helps us not retread roads you've already walked.
5. Alcohol and other substances
It's a working question, not a character test.
6. Safety
This question is here because its answer matters more than any other on the form.
7. What brings you
Check everything that applies. The rest we'll take care of in session.
8. Direction
We don't only work with what hurts, but also with what already works.
How it reaches me
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