Personal Information

First name

Last name

Gender

Male

Female

Date of Birth

Day

Month

Year

Country of Residence

Phone

Type of Session

Please select the service you wish to book:

Please describe briefly what brings you to therapy or what you would like to work on: (e.g., anxiety, depression, workplace stress, trauma, relationship issues, low motivation, etc.)

Background Information

Have you received counseling or therapy before?

Yes

Are you currently taking any psychiatric medication?

Yes

If yes, please specify:

Any diagnosed mental health condition (if applicable):

Schedule an appointment

January 2026

Week starting Sunday, January 18

Time zone: Coordinated Universal Time (UTC)Phone call

Tuesday, Jan 20

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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