GARY BUCK, PhD

Fill out the short questionnaire to help us hit the ground running on our call ⬇️

Fill out the short questionnaire to help us

hit the ground running on our call ⬇️

What type of therapy are you looking for?

Individual (for myself)

Couples (for myself and my partner)

Teen (for my child)

What is your gender identity?

Man

Woman

Other

Prefer not to say

How old are you?

How long have you been experiencing these struggles?

0-3 months

3-6 months

1-2 years

2+ years

Have you been in therapy before?

Yes

No

What is your gender identity?

Man

Woman

Other

Prefer not to say

How old are you?

Will your partner be joining you in therapy?

Yes (couples therapy)

No (individual therapy)

Not sure yet (decide later)

Are you looking for your child to start therapy?

Yes (I want therapy for my child)

No (I only need parental advice)

Not sure yet (decide later)

How are you related to your child?

I am the mother

I am the father

I am the legal guardian

Other

How old is your child?

Has your child ever been in therapy before?

No

Yes

Which state are you in? If you do not reside in STATE(S) then please leave this page now and search for a therapist within your state.

STATE

You have completed the questionnaire!

Let's get you scheduled for a complementary 20-minute consultation with one of our team members

First name

Last name

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GARY BUCK, PhD

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GARY BUCK, PhD

GARY BUCK, PhD

GARY BUCK, PhD

Fill out the short questionnaire to help us hit the ground running on our call ⬇️

Fill out the short questionnaire to help us

hit the ground running on our call ⬇️

What type of therapy are you looking for?

What is your gender identity?

What led you to consider therapy today?

How long have you been experiencing these struggles?

Have you been in therapy before?

What is your gender identity?

How old are you?

Will your partner be joining you in therapy?

What led you to consider therapy today?

Are you looking for your child to start therapy?

How are you related to your child?

How old is your child?

Has your child ever been in therapy before?

What is your child struggling with?

Which state are you in? If you do not reside in STATE(S) then please leave this page now and search for a therapist within your state.

You have completed the questionnaire!

GARY BUCK, PhD

GARY BUCK, PhD