ONLINE COUNSELING SERVICE Jeevan Jaach has initiated an Online Counseling Service for those who need Psychological Services or Guidance for everyday life stressors. We have a team of trained and experienced counselors to meet your mental health needs. Application for Individual CounselingRegistration Process: --> All details to be filled --> One ID to be provided --> Payment for First Session (950 INR - Inclusive of one time non-refundable fees ₹200/-) --> Client Consent Form to be read before signing --> Payment for recurring Individual sessions (₹750/- Per session)Please enable JavaScript in your browser to complete this form.Email *Name *FirstMiddleLastDate of Birth *Gender *MaleFemalePrefer not to sayOtherWhatsApp Number *Please provide a number which is reachable through WhatsApp.Alternative Number *Please provide a number which is reachable through call.Please attach the document to support the details provided above * Click or drag a file to this area to upload. Jeevan Jaach requires your details as well as ID copy to establish identity and maintain records. Confidentiality will be maintained. Aadhaar card/Passport/Driving license/Voter IDYou are seeking these services for *MyselfMy childMy friendOther family memberSelect the area of concern according to you *Mood disturbance- Irritability, frustration, anger, sadness, extremely happy etcMental Health conditions - Depression, Anxiety, PTSD, Bipolar Disorder etcAcademic/behavioral conditions- ADHD, Learning disability, Slow learnerBehavioral/Emotional problems - Jealousy, disobedience, argumentative, hitting, crying excessively,Academic problems- difficulty in writing, comprehending, following instructions etcFamily conflictsStrained relationshipConcerns with Self esteem/ Self imageNeurological/ developmental disorders- autism, downs syndrome etcDifficulty concerntating/ forgetfullnessAddictions- screen time, alcohol, substances etcOthersPlease select whom would you like to receive help from *Life coachPsychiatristPediatricianPsychologist/psychotherapistGuidance counselorSpecial educatorI dont knowWe will try our best to provide a professional as per your selection but our team will take the final decision, taking your concern in consideration.I came to know about these services from__ *Jeevan Jaach student/teacher/volunteerJeevan Jaach WebsiteWhats app/Facebook/InstagramAny other sourceYou can describe your concern here in a few lines *Submit
