Teen Counseling

Help Leigh Wayna get to know you better

Use the tab key to navigate this questionnaire and use enter key to confirm selection. Use Shift + Escape keys to exit the questionnaire
Would you like to invite your child?
What is your child’s gender identity?
How are you related to your child?
Where does your child live?
Does your child go to school?
Has your child ever been in therapy before?
When was the last time your child had thoughts about suicide?
What is your observation of these thoughts?
Do you have concerns about your child in any of these issues?
How would you rate your relationship with your child?
How would you rate your current financial status?
Who referred you to Teen Counseling?
Please mark all that apply