Transgender Spirit Counseling

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Transgender History Questionnaire

(Created by Dr. Rachael St. Claire and used with her permission)

Please note: Due to HIPAA constraints, it is not possible to save this form and complete later. It must be completed in a single session.

Step 1 of 6

16%
  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • Problem List

  • Gender Identity Information

  • Medical Information

  • Mental Health Information

  • Family Information

  • Military History

  • Educational Background

  • Religious Background

  • Life Story

  • This field is for validation purposes and should be left unchanged.

For Appointments:

Call: 720.283.3933
Email: laura.thor@hush.com
Client Portal

Recent Post

You Are Seen, Known & Loved: Psalm 139 Speaks to LGBTQ & All People

I have a counseling client whom I’ll call “Israel” because she’s always struggling against injustice and afraid that God’s love isn’t meant for her. Her pain inspires me to remind readers that while the  “clobber passages’ of the Bible have been mis-used to shame LGBTQ people, the bottom line message of the scriptures is that […]

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