I Dare you to Heal w/ Dr. Lanecha
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Reason for care
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Appointment info
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Prescreener
Reason for care
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Contact information
What's leading you to seek care at this time?
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Which of the following are you currently experiencing?
Anxiety, overthinking, worry
Self-doubt, imposter feelings, low self-worth
Depression, low mood, feeling numb
Identity confusion / feeling lost about who I am
Difficulty setting boundaries
Shame or guilt from past experiences
Relationship concerns (romantic)
Friendship concerns
Family conflict
Work / career stress or burnout
Difficulty managing anger or irritability
Difficulty sleeping / changes in appetite
Other
What, in your daily life, are these concerns impacting? (check all that apply)
My relationships
My role as a parent
My work / business / school
My sense of identity / who I am
My confidence and self-trust
My ability to speak up or be seen
Other
If you or others are in immediate danger or experiencing a medical emergency, call 911 immediately.
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