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Iowa Family Counseling LLC

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Reason for care

Select date & time

1 Appointment info

Reason for care

3 Contact information

What is the reason for seeking care?

What are the main symptoms and concerns you're wanting mental health counseling for?

Anxiety Attentional difficulties Behavioral issues Depression Grief Relationship issues Substance use Trauma Suicidal ideation/self-harm Somatic/physical symptoms Parenting 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 Other Prefer not to disclose

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

Iowa Family Counseling LLC

641.777.2774 |

Kalona

Main Location

409 B Ave
Kalona, IA 52247-7719

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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.