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Registration Form

Personal Information

Gender
Male
Female
Date of Birth
Day
Month
Year

Type of Session

Please select the service you wish to book:

Background Information

Have you received counseling or therapy before?
Yes
No
Are you currently taking any psychiatric medication?
Yes
No
Schedule an appointment
Mar - Apr 2026
SunMonTueWedThuFriSat
Week starting Sunday, March 29
Time zone: Coordinated Universal Time (UTC)Phone call
Monday, Mar 30
10:00 AM - 11:00 AM
11:00 AM - 12:00 PM
12:00 PM - 1:00 PM
1:00 PM - 2:00 PM

Please share two or three preferred days/times that suit you. Our admin team will contact you within 24–48 hours to finalize your appointment and send the meeting link.

Payment Information

Session Fee: 45–50 min session
$60
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