October 2025
Random Road with drainage
Counseling Questionnaire
After two safety incidents I asked to speak with a professional counselor. Here is my first answer to the 13-question online intake report.
Counseling Intake Questionnaire
SECTOR: Agriculture Economic Development
COUNTRY: Uganda
Entry of Service:
Arrival date in- Country (month, year): 08/2024
DOB/Age: old enough
Date Questionnaire completed:
23, August 2025
1. What led to you seeking support from Behavioral Health and Outreach Unit at this time?
Anxiety and inability to describe my opinions and fears to others.