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What is your gender?

Male

Female

Non-binary

How old are you?

What type of counseling are you looking for?

Individual counseling (for myself)

Couple counseling (for myself and my partner)

What is your relationship status?

Single

In a relationship

Married

Domestic partnership

Separated

Divorced

Widowed

Not sure

Have you ever been in counseling or therapy before?

No

Yes

How would you rate your current physical health?

Good

Fair

Poor

How would you rate your current sleeping habits?

Good

Fair

Poor

How would you rate your current eating habits?

Good

Fair

Poor

How would you rate your current financial status?

Good

Fair

Poor

Are you currently experiencing overwhelming sadness, grief, or depression?

No

Yes

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.

Not at all

Several days

More than half the days

Nearly every day

Over the past 2 weeks, how often have you been bothered by any of the following problems:Little interest or pleasure in doing things.

Not at all

Several days

More than half the days

Nearly every day

Over the past 2 weeks, how often have you been bothered by any of the following problems:Feeling down, depression or hopeless.

Not at all

Several days

More than half the days

Nearly every day

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.

Not at all

Several days

More than half the days

Nearly every day

Over the past 2 weeks, how often have you been bothered by any of the following problems:Feeling tired or having little energy.

Not at all

Several days

More than half the days

Nearly every day

Over the past 2 weeks, how often have you been bothered by any of the following problems:Poor appetite or overeating.

Not at all

Several days

More than half the days

Nearly every day

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.

Not at all

Several days

More than half the days

Nearly every day

Over the past 2 weeks, how often have you been bothered by any of the following problems:Trouble concentrating on things, such as reading the newspaper or watching television.

Not at all

Several days

More than half the days

Nearly every day

Over the past 2 weeks, how often have you been bothered by any of the following problems:Thoughts that you would be better off dead or of hurting yourself in some way.

Not at all

Several days

More than half the days

Nearly every day

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?

Not difficult at all

Somewhat difficult

Very difficult

Extremely difficult

Are you currently experiencing anxiety, panic attacks or have any phobias?

No

Yes

Are you currently experiencing any chronic pain?

No

Yes

Are you currently employed?

No

Yes

Do you consider yourself to be spiritual or religious?

No

Yes

Do you have any problems or worries about intimacy?

No

Yes

What is your orientation?

Straight

Gay

Lesbian

Bisexual

Not sure

Are you currently taking any medication?

No

Yes

When was the last time you had a plan to commit suicide?

Never

Over a year ago

Over 3 months ago

Over a month ago

Over a week ago

This week

How often do you drink alcohol?

Never

Infrequently

Monthly

Weekly

Daily

Who referred you to BetterHelp?

A friend or family member

My doctor

My therapist

Searched online

Saw an ad

Saw a social media post

Read a story about it

Heard about it on the radio

Other

Which country are you in?

Next

Which state are you in?

What is your preferred language?

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Over 500,000 people signed up. What do they think?

"Dr. Blackwell is very down to earth and caring! I feel that I have made so much progress on the issues that we have been working through. "

- Written 2 days ago by S.A. for Dr. Ophelia Blackwell (PhD, LCPC, NCC)

"Addie is the best! She listens to me, provides excellent feedback, and never judges! I am so thankful for all her help!"

- Written 2 days ago by L.A. for Adrienne Kovar (LICSW)

"Wendy is truly compassionate and helpful. "

- Written 2 days ago by S.U. for Wendy Galyen (LCSW,DCC)

"She is very kind, respectful, and honest. I love her counseling because she puts words to my feelings and it all makes sense."

- Written 2 days ago by A.Y. for Potoula Diaz (MS, LMHC, LMFT)

"She is very open and listens intently. Through our first video session I knew I found someone great and someone I can trust! I’d recommend her to anyone and everyone!"

- Written 2 days ago by E.M. for Guileine Kraft (Ph.D.,LCSW-C)

"April has been awesome so far (we had our first one-on-one earlier today). She sees where I need help and focuses on that area. Definitely would recommend. "

- Written 3 days ago by R.A. for April Shields (MS,LPC,CDWF)

"Friendly, welcoming, and engaging. I always feel like we have productive sessions and I feel comfortable talking to him. "

- Written 3 days ago by N.I. for Robert Cline (MSW,LCSW)

"Jessica is very friendly. She makes you feel comfortable and safe. She is a good listener and always has the best guidance to offer. "

- Written 3 days ago by J.E. for Jessica Slash (LCSW)

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