Session Check-In

Welcome! Please sign in with your client number and answer a few quick questions. Your provider will be notified that you are here. We do not ask for your name.

Your client number Date

On a scale of 1-10, how satisfied are you with your life right now? (10 = most satisfied, 1 = least satisfied)

1 - least satisfied10 - most satisfied

In general, would you say your health is:

Would you rate your current relationships as:

You're checked in.

Thank you - your provider has been notified that you are here.

We want to make sure you are safe. Because you noted thoughts or actions of self-harm, please tell your provider right away. If you are in danger or need to talk to someone now, call or text 988 (Suicide & Crisis Lifeline), or call 911.

Session Check-In

Are you ready to be a real life hero? You can make a difference through your financial contribution as well as donating your time.

CCS is not a crisis center~ If you are experiencing thoughts of self harm or suicide dial 988

:::

CCS is not a crisis center~ If you are experiencing thoughts of self harm or suicide dial 988 :::