Request appointment | Healthy Connections Counseling, LLC

Healthy Connections Counseling, LLC

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Reason for care

Select date & time

1 Appointment info

2 Prescreener

Reason for care

3 Contact information

Presenting problem and specialty fit?

For example: seeking support for?

Substance Use Life Transitions Are you looking for individual, couples, or family therapy? Is there a specific therapy approach or style you are looking for? Are there cultural, gender, faith-based, or identity considerations that are important for your care? Or something else?

Stressors?

Recent move or relocation Pregnancy or postpartum adjustment Grief Social isolation Major life transitions Work stress/ Job loss/ School or academic stress Family conflict/ Parenting stress Marital or relationship problems/ Divorce or breakup Medical issues; Chronic Pain History of trauma Other:

Symptoms?

Irritability or anger Feeling overwhelmed Substance use concerns Suicidal Ideation Depressed Other:

Functioning?

For example: How are these concerns affecting your daily life, work, school, relationships, or sleep? Have your symptoms been getting worse, staying the same, or improving? Are there particular triggers or situations that make things harder?

Limited to 600 characters

Reason for seeking therapy?

Attentional difficulties [ADHD] Anxiety Trauma Grief Depression Relationship ended; divorce, breakup

Treatment History

Have you been in therapy before?

Have you ever worked with a psychiatrist or been prescribed mental health medication? Have you ever been hospitalized for mental health or substance use concerns? Was previous treatment helpful? Was previous treatment unhelpful?

Safety and level of care

Are you having any current thoughts of hurting yourself or someone else? Have you had any recent suicide attempts, self-harm, or violent behavior? Are you experiencing hallucinations, severe paranoia, or feeling disconnected from reality? Do you feel safe where you live?

For medical emergencies, contact your healthcare provider or call 911. For mental health crises, call or text 988.

Healthy Connections Counseling, LLC

240.938.9146 |

Potomac, MD

Main Location

11810 Grand Park Ave #500
Potomac, MD 20852-8679

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THE CLIENT PORTAL IS NOT TO BE USED FOR EMERGENCY SITUATIONS. IF YOU OR OTHERS ARE IN IMMEDIATE DANGER OR EXPERIENCING A MEDICAL EMERGENCY, CALL 911 IMMEDIATELY.