Get Started - Help Us Match You

What type of therapy are you looking for?* This field is required.Let’s guide you through the process of finding the right therapist for you! We’ll begin with a few essential questions.

Individual

Couples

Teen

Family

Partner's name* This field is required.

First Name

Last Name

Partner's email* This field is required.

example@example.com

Partner's date-of-birth* This field is required.

Date

What is your teen's name?* This field is required.

First Name

Last Name

What is your teen's DOB?* This field is required.

Date

What state are you currently living in?* This field is required.

Which county are you in?* This field is required.

What is your gender identity?* This field is required.

Woman

Man

Non Binary

Transfeminine

Transmasculine

Agender

I don't know

Prefer not to say

Other

How old are you?* This field is required.

What is your relationship status?* This field is required.

Single

In a relationship

Married

Divorced

Widowed

Other

How important is religion in your life?* This field is required.

Very important

Important

Somewhat important

Not important at all

Which religion do you identify with?* This field is required.

Christianity

Islam

Judaism

Hinduism

Buddhism

Other

Prefer not to say

Have you ever been in therapy before?* This field is required.

YESNO

What led you to consider therapy today?* This field is required.

I've been feeling depressed

I feel anxious or overwhelmed

My mood is interfering with my job/school performance

I struggle with building or maintaining relationships

I can't find purpose and meaning in my life

I am grieving

I have experienced trauma

I need to talk through a specific challenge

I want to gain self-confidence

I want to improve myself but I don't know where to start

Recommended to me (friend, family, doctor)

Just exploring

Other

What are your expectations from your therapist? A therapist who...* This field is required.

Listens

Explores my past

Teaches me new skills

Challenges my beliefs

Assigns me homework

Guides me to set goals

Proactively checks in with me

Other

I don't know

Are you currently experiencing overwhelming sadness, grief, or depression?* This field is required.Psychotherapy can serve as an effective treatment for clinical depression.

YESNO

Moving or speaking so slowly that other people could have noticed? Or the opposite - being so fidgety or restless that you have been moving around a lot more than usual.

Not at all

Several days

More than half the days

Nearly every day

Feeling down, depressed or hopeless.

Not at all

Several days

More than half the days

Nearly every day

Trouble falling asleep, staying asleep, or sleeping too much.

Not at all

Several days

More than half the days

Nearly every day

Feeling tired or having little energy.

Not at all

Several days

More than half the days

Nearly every day

Poor appetite or overeating.

Not at all

Several days

More than half the days

Nearly every day

Feeling bad about yourself - or that you are a failure or have let yourself or your family down.

Not at all

Several days

More than half the days

Nearly every day

Trouble concentrating on things, such as reading the newspaper or watching television.

Not at all

Several days

More than half the days

Nearly every day

Thoughts that you would be better off dead or of hurting yourself in some way.

Not at all

Several days

More than half the days

Nearly every day

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?

Not difficult at all

Somewhat difficult

Very difficult

Extremely difficult

Are you currently employed?* This field is required.

YESNO

Do you have any problems or worries about intimacy?

YESNO

How often do you drink alcohol?

Never

Infrequently

Monthly

Weekly

Daily

When was the last time you thought about suicide?* This field is required.If you are having suicidal thoughts, please call or text 988

Never

Over a year ago

Over 3 months ago

Over a month ago

Over 2 weeks ago

In the last 2 weeks

Are you currently experiencing anxiety, panic attacks or have any phobias?

YESNO

Are you currently taking any medication?* This field is required.

YESNO

How would you rate your current sleeping habits?Many adults who have generalized anxiety disorder also suffer from sleep problems.

Good

Fair

Poor

How do you prefer sessions?* This field is required.

In-Person

Tele-Health

In-Person & Tele-Health

Don't have a preference

When do you prefer sessions?* This field is required.

Mornings

Afternoons

Evenings

How do you prefer to communicate with your therapist?* This field is required.

Mostly via messaging

Mostly via phone or video sessions

Not sure yet (decide later)

Are there any specific preferences for your therapist?* This field is required.

Male therapist

Female therapist

Christian-based therapy

Older therapist (45+)

Non-religious therapist

Black Therapist

Bi-lingual therapist (Spanish)

Bi-lingual therapist (Haitian creole)

Who referred you to Dr. Tripp & Associates?* This field is required.

Instagram

Friend or family member

Radio

YouTube

Magazine or newspaper

Facebook

Google search

Mailer/Direct Mail

Other

What is your preferred language?* This field is required.

Name* This field is required.

First Name

Last Name

Please enter your phone number* This field is required.

Area Code

Phone Number

Please enter date of birth * This field is required.

Date

Please enter your email* This field is required.

example@example.com

Insurance Options* This field is required.

How would you like to pay for your session?

I want one session - $100

I am interested in a bundling my sessions - 4 for $340

Member ID (Located on Insurance Card)

I prefer a therapist with experience in...Are there any issues you'd like to focus on? We want to match you with a therapist who suits your needs.

Depression

Stress and anxiety

Coping with addictions

LGBTQ+ related issues

Relationship issues

Family conflicts

Trauma and abuse

Coping with grief and loss

Intimacy related issues

Eating disorders

Sleeping disorders

Parenting issues

Motivation, self-esteem, and confidence

Anger management

Career difficulties

Bipolar disorder

Coping with life changes

Executive and professional coaching

Compassion fatigue

Concentration, memory, and focus (ADHD)

Additional focus areas I prefer...

Communication problems

Life purpose

Isolation/loneliness

Self-love

Social anxiety and phobia

Guilt and shame

Post-traumatic stress

Panic disorder and panic attacks

Control issues

Forgiveness

Caregiver issues and stress

Pregnancy and childbirth

Divorce and separation

I have read, received, and agree to the following forms: Consent for Treatment, Cancellation Policy, Client Handbook, Consent for minor usage, Financial Responsibility Disclaimer, Notice of Privacy Policy, Rights and Responsibilities, Third-Party Financial Responsibility, Consent for Telehealth Consultation, Informed Consent for Psychotherapy, and consent to receive text messages and other communications from Dr. Tripp and Associates about my account and DTAA’s services.* This field is required.

Clear

What brings you here?Tell your therapist what's on your mind.

0/500