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Nova Counseling and Wellness, PLLC

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Reason for care

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1 Appointment info

Reason for care

3 Contact information

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?

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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 Suicidal ideation / attempt in the past None of these apply

If you or others are in immediate danger or experiencing a medical emergency, call 911 immediately.

Nova Counseling and Wellness, PLLC

704.370.9405 |

Charlotte, NC

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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.