Client Preference - Counseling World

Therapist cultural that

Client Name

First

Last

Email

Phone

Date

Please select the gender you prefer for your therapist:

Please select the age range you prefer for your therapist:

Please select any cultural backgrounds that you feel comfortable with:

(Select all that apply)

Other cultural preference (please specify):

Which areas of specialization are important to you? (Select all that apply)

Other Specialization (please specify):

Which therapeutic approaches resonate with you? (Select all that apply)

Other Therapeutic Approaches (please specify):

How do you prefer your therapist to communicate? (Select all that apply)

(Select all that apply)

Other prefered communication (please specify):

What session frequency and duration do you prefer?

Delivery Method:

Please share any other preferences or concerns you have regarding your therapist or the counseling process:

How important is it for you to find a therapist that matches your preferences?

Please indicate your preferences for the therapist you would like to engage with during your telehealth counseling sessions. You can select multiple options for each question where applicable.