• Before the form starts:
    A brief first step—no commitment required.

    This questionnaire helps me understand what brings you in,
    any prior treatment, and what you’re hoping for going forward.

    You don’t need to have everything figured out—
    brief, honest answers are enough.

     

    If it seems like a good fit, 

    I’ll follow up personally with next steps, typically within 1-2 business days.

     

    Takes about 3-5 minutes

    All information is private and confidential 

  • If you have a mental health emergency: DO NOT complete this form, instead please call 911, call/text 988 or call the 24/7 Georgia Crisis and Access line at 800-715-4225 (or text 741741).

  • Pre-scheduling questionnaire

    Pre-scheduling questionnaire

    This form is to be completed directly by the prospective patient only.  No one else may complete this form on behalf of someone else.
  • What would you most like help with at this time? (select all that apply)*
  • What are you hoping for most right now? (select up to 2)*
  • Rows
  • For any answers above other than "Not at all", how difficult have these problems made it for you to do your work, take care of things at home or get along with other people*
  • Have you ever attempted suicide?*
  • Have you ever been psychiatrically hospitalized?*
  • Are you actively meeting with a therapist or counselor*
  • Format: (000) 000-0000.

  • You must be 18 or older and a resident of Georgia.  If you do not live in the state of Georgia,          YOU MAY NOT see Dr. Williams for treatment due to state medical licensing laws. 

  • You have reached the end of this questionnaire.

    Make any desired changes before hitting the submit button to send your responses directly to Dr. Williams.

     

  • Should be Empty: