top of page

Please complete the questionnaire below, it is for me to be able to support you with your healing journey.

 Once completed click the submit button.

This questionnaire is kept confidential and will only be kept for the duration we are working together. 

Disclaimer *

I am not a therapist or doctor, but I can still support you.

Thank you!

Mell's Safe Space Questionnaire 
How often have you experienced low, anxiety or depression?
What methods or activities are you completing weekly or daily to help with your wellbeing? Please tick all that apply.
Do you use Wellbeing apps on your device?
Are you fed up with feeling the way you do?
How would you like me to suppot you? Please tick all that apply.
Are you fed up with feeling the way you are?

Thanks for submitting!

bottom of page