Find a therapist - Alamaani Teaching Agency

Your Child’s Therapist Awaits

Helping children grow with confidence, clarity, and support.

Find a Therapist

Section 1: Parent / Guardian Information

Full Name *

Relationship to Child *

Mother

Father

Guardian

Contact Email *

Phone Number *

Address *

Section 2: Child Information

Child’s Full Name *

Date of Birth *

Age

Gender

Male

Female

Section 3: Emergency Information

Emergency Contact Name

Relationship

Emergency Contact Phone

⚠️ Important: This platform is not a crisis service. If your child is in immediate danger, please contact your local emergency number right away.

Section 4: Reason for Seeking Therapy

What concerns would you like support with? (Select all that apply)

Anxiety / Worry Low mood / Sadness Anger / Emotional regulation School-related difficulties Attention or focus concerns Social skills / Friendships Family or sibling conflicts Confidence / Self-esteem Other

Please specify

Section 5: Therapy Preferences

Preferred Therapist Gender

Male

Female

No preference

Preferred Language

Preferred Session Format

Video calls (Parent + Child) Video calls (Parent only) Messaging support Combination

Preferred Availability

Morning Afternoon Evening Weekend

Section 6: Child’s Background

Has your child attended therapy before?

Yes

Is your child currently taking any medication?

Yes

If yes, please specify

Does your child have any diagnosed conditions?

Yes

If yes, please specify

Section 7: Goals for Therapy

What would you like your child to gain from therapy?

Section 8: Consent and Agreement

I confirm that I am the parent/legal guardian of the child named above.

I give permission for my child to participate in therapy through this online platform.

I understand that online therapy has limitations and is not a substitute for emergency services.

I consent to share this information for the purpose of matching my child with a licensed therapist.

I agree to the platform’s Privacy Policy and Terms of Service.

Parent/Guardian Digital Signature *

Date *

Guidance from Trusted Therapists

Connect with trusted professionals who understand and care.

Miss Walaa

Social Worker & Family Support Specialist

Mr. Xander

Educational Psychologist

Miss Shannon Ryder

Integrative Therapist & Counselling Educator

Miss Helena

Child Counsellor & Mental Health Specialist

Mr. Jordan

Child & Teen Therapist