Mental health

Your First Name
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Your Last Name
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Phone Number
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Your E-mail Address
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What type of counseling are you looking for?
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Individual counseling

What is your gender?
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How old are you?
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What is your relationship status?
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Have you ever been in counseling or therapy before?
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How would you rate your current physical health?
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Are you currently experiencing overwhelming sadness, grief, or depression?
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Field is required!
Over the past 2 weeks, how often have you been bothered by any of the following problems:
Trouble falling asleep, staying asleep, or sleeping too much.
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Feeling tired or having little energy.
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Poor appetite or overeating.
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Field is required!
Feeling bad about yourself or that you are a failure or have let yourself or your family down.
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Field is required!
Trouble concentrating on things, such as reading the newspaper or watching tv.
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Field is required!
Are you currently experiencing anxiety, panic attacks or have any phobias?
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Are you currently taking any medication?
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Are you currently experiencing any chronic pain?
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Field is required!

Couple counseling

What is your gender?
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Field is required!
How old are you?
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Field is required!
What are the benefits you're looking to achieve?
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Field is required!

Teenage counseling

What is their gender?
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Field is required!
How old is he/she?
Field is required!
Field is required!
How would you rate his/her current physical health?
Field is required!
Field is required!
Is he/she currently experiencing overwhelming sadness, grief, or depression?
Field is required!
Field is required!
Is he/she currently taking any medication?
Field is required!
Field is required!
Is he/she currently experiencing any chronic pain?
Field is required!
Field is required!
  • - How do you prefer to communicate with Dr. David? -
  • Live in Dubai or Lebanon
  • Via video sessions
- How do you prefer to communicate with Dr. David? -
Field is required!
Field is required!

Counseling is confidential but the therapist will alert you if an intervention is required.