Tell us what matters most to you
What do you want to work on?
Choose as many or as few as apply. If nothing applies, use the "Other" section at the bottom.
Current Distress Level
How distressed or overwhelmed are you feeling right now?
Life Situation
Help us recommend the most practical skills for your situation.
How I Feel
Understanding and managing how you feel.
Actions I Want to Change
Patterns you'd like to change.
My Relationships and How I See Myself
How you relate to others and to yourself.
Difficult Experiences
Things that have been hard to deal with.
Keeping Myself Safe
Behaviors that put your safety at risk.
Important: Please review these items carefully
Other Goals
Describe any other goals or concerns not listed above.
