Registration Form and Confidentiality Agreement

Family situation
Economic situation

Family Member


Father

Whether to live together
Relationship with

Mother

Whether to live together
Relationship with

Partner

Whether to live together
Relationship with

Other

Whether to live together
Relationship with
Problem Trouble

Counseling Experience and Settings


Counseling Treatment Experience
Preferred consultation time
Desired consultation frequency

Audio and video recording

Audio recording
Video recording
View the counseling agreement

Gentle reminder:

1. The relevant content you fill in is confidential and kept by a dedicated person;

2. We hope to be able to truly help you when you need it. Thank you for your trust and cooperation.

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