My name is Ana and I will be helping you connect with the right therapist. Let's get started - this form should take you about 5 minutes to fill in.
I will send you an email with your potential matches within 2 working days. In order to do so we will ask you for your email address, which will be securely stored together with other information given in this survey and automatically deleted after 4 weeks. Data collected will only be used for evaluation for providing the potential therapists and will never be shared with any other third parties. If you have any questions about your data protection or participating in this matching system feel free to Contact Us.
*Click on the "Agree and continue" button below to indicate that you have read this form and understand the information above. By clicking on the “Agree and continue” button, you are providing an online signature for your consent to give information for this therapist matching system.
*If you need urgent psychological assistance, please check out our resources section.*