Request appointment | Mend and Flow Therapeutic Solutions, PLLC

Mend and Flow Therapeutic Solutions, PLLC

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

What kind of therapy is being sought?

Individual therapy Group therapy Trauma treatment Not sure

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

Have you had any traumatic experiences? If yes, please select one or more events below

Examples of traumatic experiences include (but are not limited to) sudden violent or accidental death, exposure to violence, sexual assault/violence, childhood abuse, etc

I have not had any traumatic experiences Sudden violent or accidental death Childhood physical abuse Childhood neglect Childhood sexual abuse Unwanted sexual experience Sexual assault Physical assault Exposure to domestic violence Serious harm/injury Exposure to war or area experience effects of war Captivity Serious accident or disaster Other

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

Mend and Flow Therapeutic Solutions, PLLC

980.819.1480 |

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.