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Welcome to Luna Teletherapy!

Hey, glad you’re here. Help us pick the right therapist for you. It takes less than 2 minutes.

Full Name

Phone Number (WhatsApp preferred)

Email Address

How old are you?

How old are you?
A
B
C
D
E

What would you like to talk to a therapist about?

What would you like to talk to a therapist about?
A
B
C
D
E
F
G
H

How would you prefer to have your sessions?

How would you prefer to have your sessions?
A
B

Preferred language

Preferred language
A
B
C
D
E
F
G

When are you usually available for a session?

(Let us know your preferred days and times)

Have you ever spoken to a therapist before?

Have you ever spoken to a therapist before?
A
B

How soon would you like to start?

How soon would you like to start?
A
B
C
D

Do you give consent for us to contact you and connect you to a therapist?

Do you give consent for us to contact you and connect you to a therapist?
A
B

Privacy and Consent

At Luna, your privacy and well-being are our top priorities. Everything you share is kept confidential and used only to support your therapy, unless there’s a risk of harm or legal obligation. We use secure platforms, and while no system is perfect, we take strong steps to protect your data. You have the right to access, correct, or delete your information, and to ask questions at any time. Please read our Informed Consent (https://drive.google.com/informed-consent) and our Privacy Policy (https://drive.google.com/privacy-policy) before continuing.
Privacy and Consent