Help us match you to the right online therapist.

Please fill out this short questionnaire to provide some general and anonymous background about you and the issues you'd like to deal with in online therapy. It would help us match you with the most suitable therapist for you. Your answers will also give this counselor a good starting point in getting to know you.

What type of counseling are you looking for?

Individual counseling (for myself)

Couple counseling (for myself and my partner)

Teenage counseling (for my child)

What is your gender?

Male

Female

How old are you?

Would you like to be matched with a counselor who specializes in LGBT issues?

Yes

What are your pronouns?

She/her

He/him

They/them

Other

What is your relationship status?

Single

In a relationship

Married

Divorced

Widowed

Other

Do you consider yourself to be religious?

Yes

Which religion do you identify with?

Christianity

Judaism

Islam

Other

Would you like to be matched with a counselor who provides Christian-based counseling?

Yes

Do you consider yourself to be spiritual?

Yes

Have you ever been in counseling or therapy before?

Yes

Do you feel that your mental health is being impacted by the coronavirus outbreak?

Yes

Maybe

When was the last time you had a plan for suicide?

Never

Over a year ago

Over 3 months ago

Over a month ago

Over a week ago

This week

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

Yes

Are you currently taking any medication?

Yes

Are you currently experiencing any chronic pain?

Yes

How would you rate your current financial status?

Good

Fair

Poor

How would you rate your current sleeping habits?

Good

Fair

Poor

How comfortable are you with your identity?

Not at all

A little comfortable

Somewhat comfortable

Very comfortable

How much of your LGBT+ identity is contributing to your mental health concerns?

Not at all

Contributing a little bit

Somewhat contributing

Contributing a lot

Solely contributing

Do you prefer to be matched with a counselor who is part of the LGBT community themself?

Yes

No preference

In order to give your counselor the right expectations, please answer a few questions about your spiritual background. How long has your faith been important to you?

Less than a year

1-3 years

More than 3 years

My whole life

Which best describes your prayer life?

I never pray

I occasionally pray

I pray daily

I pray throughout my day

Which best describes the nature of the counseling you are seeking?

Mental health counseling from a Christian perspective

Spiritual counseling on primarily faith-based matters

Holistic counseling addressing both psychological and spiritual components

Other

What are your preferences around the spiritual component of your counseling (check all that apply):

I would prefer to keep our sessions strictly clinical

I would welcome any biblical wisdom

I would be open to my counselor recommending spiritual disciplines

I would be interested in my counselor incorporating prayer into our sessions

Who referred you to BetterHelp?

Youtube

Friend or family member

Snapchat

Social media post

Podcast

Poster or billboard

TV ad

Radio

Other

Which podcast?

Which country are you in?

Which state are you in?

What is your preferred language?

Please mark all that apply

I'm a student I'm a veteran I'm disabled I'm unemployed I'm employed but my income is low I'm financially impacted by the Coronavirus outbreak Next

Help us match you to the right counselor.

Help us match you to the right online therapist.

You've completed the questionnaire!

Help us match you to the right counselor.

Help us match you to the right online therapist.

You've completed the questionnaire!

Your session is about to expire!