Request appointment | Harper Therapy Group

Harper Therapy Group

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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?

If you are currently suicidal or homicidal and need immediate support, please reach out to your doctor, hotline, or if safe travel to an emergency room or urgent care for immediate support and evaluation.

Anxiety Attentional difficulties Behavioral issues Couples Therapy Depression Family Therapy Grief & Loss Mood Disorder Substance Use/Abuse Thought Disorder Trauma Child/Adolescent (Check if in this age range) Young Adult/Adult (Check if in this age range) Older Adult (Check if in this age range) Other:

What kind of care is being sought?

We do not prescribe or conduct testing. We can support with referrals if you need help finding someone.

Psychotherapy Medication Dietitian Not sure Other

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

Please use this space as a chance to explain in more detail anything you feel important for our staff to know about your needs, preferences, or history.

Limited to 600 characters

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

Harper Therapy Group

571.278.2320 |

Fairfax

Main Location

3545 Chain Bridge Road Suite 201
Fairfax, VA 22030-2708

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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.