Intencionalis
Clinic of Psychotherapy
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About
About us
Therapy
Team
Blog
Questionnaire
FAQ
Contact
Professionals
PT
Book a session
About you
What is your gender?
Female
Male
Non-binary
Another identity
Prefer not to answer
What is your age?
*
About your request
What led you to seek psychotherapy?
*
Lately I have been feeling depressed
I experience anxiety and tension
I am going through grief
I have difficulties in romantic relationships
I was advised by another person or professional
Work or study-related problems
I have dreams/nightmares I would like to understand better
I have difficulty concentrating
I need to work on my self-esteem
I have sexual or intimacy difficulties
Current or past trauma
I find it difficult to socialise
My life currently feels without purpose
Other reason
What do you expect from psychotherapy?
*
Symptom relief
Self-control and clarity
Overcoming trauma
Greater emotional control
Identifying and changing repeated behaviour patterns
Dealing with family situations
Defining what I want for this stage of my life
Other goal
Is there anything you would like the Clinical Director to know before contacting you?
Preferences
Which psychotherapy format would you prefer?
*
In-person
Online
No preference
Which therapist gender would you prefer?
*
Female
Male
No preference
Contact details
Website
Name
*
Email
*
Mobile phone
*
I understand that the submitted data will be handled confidentially to analyse and respond to my psychotherapy request.
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