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KRISTINA SCAGLIONE, LCSW-R
Psychotherapy & Social Work

Anchored & Authentic Approaches

You don’t need more therapy.
You need the right kind.

ABOUT THERAPY
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New Client Form

How did you hear about me?

Age

Why are you seeking therapy?

Primary issue you would like to work on:

Have you been to therapy before?

If yes...

Have you ever been hospitalized for your mental health?

If yes...

What qualities would you like in your therapist?

Your general availability?

Best phone number to reach you:

First Name

Last Name

Email

Thank you for sending me your information. I will be in touch, shortly.

KRISTINA SCAGLIONE, LCSW-R
Psychotherapy & Social Work

Anchored & Authentic Approaches

National Association of Social Workers (NASW)
National Alliance on Mental Illness (NAMI)
Psychology Today Contributor
WPATH Member 2024

WPATH badges-2024

Copyright © 2022 Kristina Scaglione, LCSW-R. All rights reserved.

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