• Virsentio DirectMatch Form

    Men's On-ramp to Therapy

  • Answer a few questions about what's going on and what you're looking for. Should take 5-7 minutes. Once we get it, a real life human will review and reach out with options from our network of therapists for men. Quick, easy, handled for you.

  • Quick Note: Right now we work with men 18 and older living in the US, and our therapists don't take Medicare or Medicaid. If that's your coverage, the number on the back of your card can help you find someone who does. 

    We connect men to individual psychotherapy, or "talk" therapy. We do not have psychiatrists or physicians for medication management in our network.

    This form isn't monitored around the clock. If you're having thoughts of harming yourself or someone else, please don't wait on this form. Call or text 988 now, any time, day or night. For emergencies, call 911.

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  • The Basics

  • Format: (000) 000-0000.

  • What's Going On

  • What best describes why you're reaching out?*
  • What do you want to work on?*

  • A Little About You

  • Relationship status*
  • Do you have kids?*
  • Have you been to therapy before?*
  • Select any that apply to you.

  • What you'd want therapy to be like

    No wrong answers here. If you're not sure, just pick what feels closest.
  • How do you want your sessions to run?*
  • What do you want from your therapist?*
  • What do you want to focus on?*

  • Your Therapist

  • Rank the therapist style you’d prefer most to least:*
  • How important are these therapist traits?*
    Rows
  • Rank these from most to least important:*

  • Payment and Schedule

  •  
    Please note: therapists in our network don't accept Medicare or Medicaid. If that's your coverage, the number on the back of your card can help you find someone who does.

  • Do you want to use insurance?*
  • If you pay out of pocket, what's your session budget?
  • When are you available for a weekly session? Check all that work. (min. of three)*
    Rows

  • Location

  • Virtual or in-person?*
  • How far would you travel? Driving, transit, or walking

  • Anything else?

  • How did you hear about Virsentio?*

  • Want more hands-on help?

    Work one on one with your own Client Advisor.

  • Starting therapy can be easier with someone to guide you.

    With our Foundations Program, you'll start with a discovery consultation to talk through your situation in depth, so we can dig beneath the surface and work with you to find the best match.

    Beyond finding your therapist, your Client Advisor is your guide through the first few months of therapy: answering questions, explaining what's actually happening, and providing a little accountability when you need it.

    Totally optional. Either way, we'll still search our network and get back to you with the therapists we'd recommend.

  • Would you like to hear more about our paid Foundations Program?
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