What type of care are you looking for?
Which country are you in?
United States of America
Canada
What is your gender identity?
How old are you?
Select your age
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51
52+
What is your relationship status?
Do you consider yourself to be spiritual?
Have you ever been in counseling or therapy before?
What led you to consider Psyvo Health today?
What are your expectations from your clinician? A clinician who...
How would you rate your current physical health?
How would you rate your current eating habits?
Are you currently experiencing overwhelming sadness, grief, or depression?
Over the past 2 weeks, how often have you been bothered by any of the following problems:
Little interest or pleasure in doing things.
Over the past 2 weeks, how often have you been bothered by any of the following problems:
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.
Over the past 2 weeks, how often have you been bothered by any of the following problems:
Feeling down, depressed or hopeless.
Over the past 2 weeks, how often have you been bothered by any of the following problems:
Trouble falling asleep, staying asleep, or sleeping too much.
Over the past 2 weeks, how often have you been bothered by any of the following problems:
Feeling tired or having little energy.
Over the past 2 weeks, how often have you been bothered by any of the following problems:
Poor appetite or overeating.
Over the past 2 weeks, how often have you been bothered by any of the following problems:
Feeling bad about yourself - or that you are a failure or have let yourself or your family down.
Over the past 2 weeks, how often have you been bothered by any of the following problems:
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?
Are you currently employed?
Do you have any problems or worries about intimacy?
How often do you drink alcohol?
Are you currently experiencing anxiety, panic attacks or have any phobias?
Are you currently taking any medication?
How would you rate your current financial status?
How do you prefer to communicate with your clinician?
Who referred you to Psyvo?
What is your preferred language?
English
Spanish
French
Mandarin
Vietnamese
American Sign Language
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