Request appointment | Mayhem and Tranquility LLC

What is the reason for seeking care?

Anxiety Attentional difficulties Behavioral issues Depression Grief Relationship issues Substance use Trauma Other

What mental health concerns or treatment have occurred in the past?

In therapy now In therapy in the past Taking psychiatric medication now Taken psychiatric medication in the past Hospitalized for mental health reasons now or recently Hospitalized for mental health reasons in the past Known neurologic or genetic disorder Attempted suicide in the past None of these apply

Do you have a history of trauma (neglect, bullying, emotional, physical, or sexual abuse?)

You do not need to go into detail here, please just indicate if you have a prior history.

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