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Home
New Clients
About
Our Team of Therapists
Counseling Services
Internship Opportunities
Services
Therapy Groups
Intensive Outpatient Programs
Contact
TC Blog
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YOUR CART
Taking Control New Client Form (English) click to dowload
Nuevo Formulario de Cliente - haga clic para descargar
New Client Survey
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How did you hear about Taking Control Counseling Services?
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Referral from doctor / hosital
Referral from school
Internet Search
Friend or Family Member
Advertisement
Community Event
Other
If Other please specify:
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What is your age?
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Less than 13
13-18
19-25
26-35
36-50
Over 50
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What is your household income?
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Less than $10,000
$10,001 - $25,000
$25,001 - $40,000
$40,001 - $70,000
$70,001 - $100,000
Greater than $100,000
Prefer not to say
Will this be your first time trying therapy?
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Yes I have never been to a therapist or counselor
Yes but I have spoken with a counselor at school before
No I have seen a therapist before
No but I have only done group / inpatient therapy
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