Beyond the Root Counseling and Consulting/Tawanna Hudson, LCSW
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Reason for care
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What is the reason for seeking care?
Anxiety
Attentional difficulties
Behavioral issues
Depression
Grief
Relationship issues
Substance use
Trauma
Other
What mental health concerns or treatment have occurred in the past?
In therapy now
In therapy in the past
Taking psychiatric medication now
Taken psychiatric medication in the past
Hospitalized for mental health reasons now or recently
Hospitalized for mental health reasons in the past
Known neurologic or genetic disorder
Attempted suicide in the past
None of these apply
Are you a practicing therapist looking for therapy?
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How long have you been experiencing the concerns that brought you here?
Are you currently experiencing any thoughts of harming yourself or others?
Have there been any recent major crises (loss, trauma, hospitalization)?
What are you hoping to gain from therapy right now?
Have you worked with a therapist before? What worked well and what didn’t? When was your last session?
Have you ever been diagnosed with a mental health condition? If so, by whom?
Are you currently taking any psychiatric medications?
Have you been hospitalized for mental health concerns in the past 12 months?
If you or others are in immediate danger or experiencing a medical emergency, call 911 immediately.
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