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Type of Counselling




Edu. Qualification:

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You are consulting for:

Did you consult anyone before for the mentioned problems?

1. Yes (specify duration of treatment, give a brief account of treatment received so far)

2. No


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How did you come to know about this website?

1. Through a client

2. Through a clinician

3. Through internet

4. Other Sources


Since how long you have been facing these problems (specify duration in days, weeks, months or years)

Briefly describe your problems:


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