We have created an online assessment form that helps to gather some background information before you undertake an initial appointment with a care provider (such as a psychologist or psychiatrist).  By clicking the link below, you will be taken to the pre-assessment form. Once you submit your answers, a report will be automatically compiled and sent to your email.   


This survey helps your treatment provider to get a sense of any mental health symptoms or issues. 

It does not provide a formal diagnosis. 

We treat your information confidentially, we don't share anything. It goes to your email only.


This survey is intended to be used by either a patient who wants to compile their information for an initial appointment. Your  therapist might send you the link to gather your info to make their assessment session more efficient. In any case the info only goes to you, so remember to print it off and take it to your appointment


Our system is HIPPA compliant, but we suggest you a email account you trust.

If you'd like to see what the report looks like once completed, click on the button below to view the sample report.