Balance Counseling and Recovery
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Reason for care
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Appointment info
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Prescreener
Reason for care
3
Contact information
What is the reason for seeking care?
Anxiety
Attentional difficulties
Behavioral issues
Depression
Grief
Relationship issues
Substance use
Trauma
Other
What mental health concerns or treatment have occurred in the past?
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
To help us match you with the best clinician. Please indicate what type of intervention are you seeking
Individual Counseling
Adolescent Counseling
Couples/marriage counseling
Ketamine Assisted Therapy
Rapid Resolution Therapy
EMDR
Substance use
To help us match you with the appropriate provider? What type of therapy are you interested?
Mark all that apply
Individual Counseling
Couples/Marriage counseling
Family
Rapid Resoultion Therapy (not covered by insurance)
Ketamine Assisted Therapy (partially covered by some insurance companies)
Adolescent
Substance Use
If you or others are in immediate danger or experiencing a medical emergency, call 911 immediately.
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