Let's find the best therapist for you
Having a therapist you feel connected to is key. We'll ask you some questions to pair you with a licensed therapist who fits your therapy needs and preferences.
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I Consent
First, please tell us a little about yourself.
This information will be kept confidential and helps us ensure we're able to provide you with care.
First Name
*
Last Name
*
Zip Code
*
Street Address
Street Address Line 2
City
State / Province
What can we help you with today? (select all that apply)
*
Self-Care
Depression
Anxiety
Insomnia
Panic
OCD
PTSD
Social Anxiety
Phobia
Postpartum Depression
Burnout
Eating Disorders
Other
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You're in the right place.
We're glad you're here. Our providers can diagnose what's going on and get you on the right treatment, so you can get back to being you.
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Over the past 2 weeks, how often have you experienced the following?
1/9
Little interest or pleasure in doing things.
*
Nearly every day
More than half of days
Several days
Not at all
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Over the past 2 weeks, how often have you experienced the following?
2/9
Feeling down, depressed, or hopeless.
*
Nearly every day
More than half of days
Several days
Not at all
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Over the past 2 weeks, how often have you experienced the following?
3/9
Trouble falling or staying asleep, or sleeping too much.
*
Nearly every day
More than half of days
Several days
Not at all
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Over the past 2 weeks, how often have you experienced the following?
4/9
Feeling tired or having little energy.
*
Nearly every day
More than half of days
Several days
Not at all
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Over the past 2 weeks, how often have you experienced the following?
5/9
Poor appetite or overeating.
*
Nearly every day
More than half of days
Several days
Not at all
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Over the past 2 weeks, how often have you experienced the following?
6/9
Feeling bad about yourself - or that you are a failure or have let yourself or your family down.
*
Nearly every day
More than half of days
Several days
Not at all
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Over the past 2 weeks, how often have you experienced the following?
7/9
Trouble concentrating on things, such as reading the news or watching television.
*
Nearly every day
More than half of days
Several days
Not at all
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Over the past 2 weeks, how often have you experienced the following?
8/9
Moving or speaking slowly that other people have noticed. Or the opposite - being so restless or fidgety that you have been moving around a lot more than usual.
*
Nearly every day
More than half of days
Several days
Not at all
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Over the past 2 weeks, how often have you experienced the following?
9/9
Thought that you would be better off dead, or of hurting yourself in some way.
*
Nearly every day
More than half of days
Several days
Not at all
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You indicated that you have had some thoughts about hurting yourself or that you'd be better off dead.
Would you describe these thoughts recently as:
*
A vague or general thought or feeling
Something I have made specific plans for
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Unfortunately, we can't accept you at this time.
Treating certain complex conditions requires closer interaction with a clinical provider than we can provide right now. Please visit/contact your referring provider (doctor, therapist, counselor) to discuss other clinical treatments. If you’re planning to hurt yourself, it’s important for you to get help right away. Your health is very important to us. If you are in distress or thinking about hurting yourself, please seek help using these crisis resources at any time.
Emergency Resources
Suicide and Crisis Lifeline - 988 | Emergency Services - 911
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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?
*
Extremely Difficult
Very Difficult
Somewhat Difficult
Not Difficult At All
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Over the past 2 weeks, how often have you been bothered by the following problems?
1/7
Feeling nervous, anxious, or on edge.
*
Nearly every day
More than half of days
Several days
Not at all
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Over the past 2 weeks, how often have you been bothered by the following problems?
2/7
Not being able to stop or control worrying.
*
Nearly every day
More than half of days
Several days
Not at all
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Over the past 2 weeks, how often have you been bothered by the following problems?
3/7
Worrying too much about different things.
*
Nearly every day
More than half of days
Several days
Not at all
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Over the past 2 weeks, how often have you been bothered by the following problems?
4/7
Trouble relaxing.
*
Nearly every day
More than half of days
Several days
Not at all
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Over the past 2 weeks, how often have you been bothered by the following problems?
5/7
Being so restless that it is hard to sit still.
*
Nearly every day
More than half of days
Several days
Not at all
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Over the past 2 weeks, how often have you been bothered by the following problems?
6/7
Becoming easily annoyed or irritable.
*
Nearly every day
More than half of days
Several days
Not at all
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Over the past 2 weeks, how often have you been bothered by the following problems?
7/7
Feeling afraid as if something awful might happen.
*
Nearly every day
More than half of days
Several days
Not at all
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Have you tried anxiety or depression treatment before?
*
Yes
No
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What type of treatment have you tried (select all that apply):
*
Antidepressants (e.g. lexapro, wellbutrin)
Seeing an in-person therapist
Seeing an online therapist
Other prescriptions (e.g. xanax, ambien)
None of the above
Other
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Have you ever attempted suicide before?
*
Yes
No
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When did your last suicide attempt occur?
*
Within the last 12 months
1-5 years ago
6-10 years ago
More than 10 years ago
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Have you ever been told by a doctor that you have schizophrenia or psychosis?
*
Yes
No
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Do you have health insurance?
*
Yes
No
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Your insurance may cover all or some of your care
Let’s check your coverage to understand your options.
Name of Insurance Card
First Name
*
Last Name
*
Insurance Company
*
Aetna
Cigna
Blue Cross Blue Shield
United Healthcare
Other
Member ID
*
Group ID
*
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We can provide you with the personal care you need. Now let’s setup your account.
After, we’ll collect additional clinical information that will help your provider deliver great care. Our Telehealth Consent and Notice of Privacy Practices provide important information about the service we provide. By proceeding, you consent to them, and agree to adhere to our Members Rights and Responsibilities terms.
Please enter your best email to get access to the patient portal
*
example@example.com
Please enter your best phone number so you can schedule your appointment
*
Please enter a valid phone number.
Select your birthday
*
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Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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