Please complete this form to the best of your ability.

This section helps to give the therapist who will be analyzing your responses essential background information to help make your plan is as effective as possible

Section A

Name:Email:What is your biggest struggle at this point? Can you narrate 3 examples of how this problem affects your everyday life?What is an important long term goal you have that this big struggle is obstructing?What or who would you consider as to be your biggest enemy/obstacle to your progress with this long term goal?What immediate goal would you like to achieve in relation to your biggest struggle?What would you be doing differently if you achieve the above stated goal?What or who would you consider as to be your biggest enemy/obstacle to your progress with this immediate goal?Why did you choose to complete this questionnaire at this stageHow did you learn about StressTherapist.net?

Section A

Section B

How I describe myself