Intentions to Seek Counseling

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For each of the following problems, please indicate the likelihood that you would seek counseling if you were experiencing the problem.

  1. 1

    Weight control

  2. 2

    Excessive alcohol use

  3. 3

    Relationship difficulties

  4. 4

    Concerns about orientation towards the other gender

  5. 5

    Depression

  6. 6

    Conflicts with parents

  7. 7

    Speech anxiety

  8. 8

    Difficulties dating

  9. 9

    Choosing a major

  10. 10

    Difficulty in sleeping

  11. 11

    Drug problems

  12. 12

    Inferiority feelings

  13. 13

    Test anxiety

  14. 14

    Difficulties with friends

  15. 15

    Academic work procrastination

  16. 16

    Self-understanding

  17. 17

    Loneliness

  18. 18

    Please Indicate Your Age:

  19. 19

    Please Indicate Your Gender:

  20. 20

    Please Indicate Your Ethnicity:

  21. 21

    Please Indicate which term best describes the area that you grew up in:

  22. 22

    Please Indicate which terms you feel best describe the size of your school

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