Mental Health Screening

A brief screening to help identify areas of concern and connect patients with support

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Full name*
Short text
Email address*
Email
How would you rate your current stress level? (1 = very low, 10 = very high)*
Scale
How would you rate your sleep quality? (1 = very poor, 10 = excellent)*
Scale
What is your primary area of concern?*
Multiple choice
Is there anything else you'd like us to know before your consultation?
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Mental Health Screening

A brief screening to help identify areas of concern and connect patients with support

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