What is your budget for therapy?

$69 - $79

$79 - $95

$95+

Do you have a preference for the therapist's gender

Female

Male

No preference

Do you prefer a therapist with a specific specialization

Select all that apply:

Communication and conflict resolution

Trust-building and infidelity recovery

Premarital or newlywed counseling

Parenting and family dynamics

Cultural or religious differences in relationships

No preference

What type of therapy approach to you prefer?

Select all that apply:

Practical an solution-focused (e.g., CBT, Gottman Method)

Supportive and exploratory (e.g., Emotionally Focused Therapy)

Structured and goal-oriented (e.g., DBT, nehavioral therapy)

Holistic and mind-body-based (e.g., mindfulness, somatic therapy)

Unsure, we want the therapist to guide us

Contact Information

First Name

Last Name

Email Address

Emergency Contact Information

Please agree to the terms and conditions Required

I agree to the terms and conditions

How did you hear about Shemesh Therapy?

Where are you originally from?

Where are you currently living?

What is your phone number?

'Please enter your phone number in international format (e.g., +972 52 123 4567)'

Would you be open to providing feedback after a few sessions to help us improve?

Yes

No

How old are you?

What best describes you?