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What are the primary reasons you are seeking care?

Anxiety Attentional difficulties Behavioral issues Depression Grief Interpersonal/relationship issues Trauma Other

If Other, provide reason for seeking care in your own words.

Limited to 600 characters

What experiences with mental health concerns or treatment have you had?

In therapy now In therapy in the past Taking psychiatric medication now Taken psychiatric medication in the past Hospitalized for mental health reasons now or recently Hospitalized for mental health reasons in the past Known neurologic or genetic disorder Attempted suicide in the past None of these apply

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