Questionnaire for Online Counseling
Please note that this form isn't tap-proof. To support privacy, I accept emails (PGP encryption supported: here's my PGP key). In this case, please don't forget to answer all questions of the above questionnaire in your email.
Click here, if you want to enter & submit this form using an encrypted connection.
You may want to use an anonymized email adress which you can register for free at services like Hotmail, Yahoo, GMail and many others!