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Reason for care

Select date & time

1 Appointment info

2 Prescreener

Reason for care

3 Contact information

What is the reason for seeking care?

Anxiety Depression ADHD-related Support Autism-related Support Substance Use Relationship Issues LBGTQIA+ Stress Management Obsessive Compulsions Life Transition Men's/Women's Issues Grief Trauma

What kind of care is being sought?

Individual Therapy Couples' Counseling Family Counseling ADHD/Autism Testing

Tell us about your treatment history:

In therapy now In therapy 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

If previously hospitalized, what was your discharge date and diagnosis?

Write "N/A" if this doesn't apply

Preferred Appointment Type:

In-person Telehealth

Is there anything that the practitioner needs to know?

For example: what you'd like to focus on, insurance or payment questions, etc.

Limited to 600 characters

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

Reset Button Counseling

614.931.0228 |

Columbus

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Columbus, OH 43214-3247

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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.