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SRWS

Guftagu

Therapy history taking form.

Hello, 
 
Thank you for reaching out. 
 
Plz fill your contact information correctly so that we can reach out to you easily. 
 
This is a history taking form. Everything you fill here will be kept confidential. Filling this form helps us to know you better, but does not guarantee a slot as that would depend on availability and goodness of fit.
 
You can check therapists profile on our website: www.guftagutherapy.in
 
Session charges with all therapists are INR 1200 for individual therapy online (video)/offline for individual therapy, INR 1500 for couple (online/offline) and INR 1800 for family therapy (only face to face). This is the special price offered to SRWS organization. We shall be offering 3 sessions to each individual sponsored by SRWS organization, shared decided by them. These sessions will be on weekly basis at a fixed chosen slot time.
 
**If you choose to continue to take therapy from Guftagu therapy post pro-bono sessions, you agree to pay the whole fees of Rs.1500, 1800, 2000 directly to Guftagu therapy.
 

Plz note: Aryan Somaiya only works with Queer and trans/NB individuals and charges each session may differ as per intersectionality of that individual/couple/family. 

Session fees need to be paid at the time of the booking and/or before the session. After you fill this inquiry form, if the sessions are finalized, you will be sent an informed consent form which has details on therapy process, cancellation policy and other details. You will also be sent a link on which to pay.

If you have any doubts plz feel free to ask and write to our Administrator, Parth and we shall be happy to discuss them. You can also write to him at guftagutherapy@gmail.com


Payment Details

Account Number – 919010002397715
Beneficiary name – Shaheed Ramashray Welfare Society
Bank name – Axis Bank
IFSC Code – UTIB0001084

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