Counseling Concern Checklist
Mark the concerning issues you want to discuss in your counseling session.
Which of the following concerns are you experiencing?
*
Anxiety
Depression or persistent sadness
Stress or feeling overwhelmed
Relationship issues (family, partner, friends)
Grief or loss
Self-esteem or self-worth concerns
Anger or irritability
Sleep Issues (trouble falling asleep, staying asleep, too much sleep/too little sleep)
Work or academic problems
Substance use concerns
Mood Swings
Paranoia
Eating Problems/ Body Image Concerns
Feelings of Worthlessness
Loss of Memory
Worries Too Much
Concentration/Easily Distracted
History of Abuse
Mental Health History in Family
Substance Abuse in Family
Thoughts of Suicide
Submit
Should be Empty: