Book an appointment. Name * First Name Last Name How many children or adolescents? * 1 2 3 4 5 6 Email * What specific behaviors, emotions, or concerns led you to seek therapy for your child/adolescent? * How does your child typically express emotions such as sadness, anger, fear, or frustration? * Have there been any recent changes or stressful events in your child’s life (e.g., divorce, bullying, loss, school changes)? * How would you describe your child’s relationships with immediate family members, peers, and authority figures? * What strengths, interests, or positive traits do you see in your child that you think could be nurtured through therapy? * Are there any current diagnoses, academic concerns, or prior mental health services that Donna should be aware of? * What are your goals or hopes for your child as they begin therapy at At The Well of Life? * Does your family practice any particular faith, cultural traditions, or values that you would like respected or included in your child’s therapy? * Thank you!
