Register as a participant

Please complete all relevant information as fully and accurately as you can. Your answers help your practitioner prepare and help Baseera find your best match. Our own matching algorithm uses your signup answers to suggest three candidates. Your information is private and is not published. Baseera also supports couples and group sessions. Availability depends on the practitioner, and rates vary by practitioner and session format. Confirm the rate before booking.

Register as a participant

Full name

Linking Google makes future sign-ins faster and easier and gives you access to all features.

What name would you like us to use for you?(optional)This name can be shared with your therapist instead of your legal name if you are not ready to share it yet.Date of birth(optional)Phone number(optional)

We will use this number to contact you and to send session reminders.Country of residence(optional)City(optional)Age range(optional)Therapist gender preference(optional)

Do you have any accessibility needs for your sessions?(optional)

Emergency contact

Under EU emergency regulations, we ask for a contact we can reach if needed.

Contact full nameContact phone number

Emergency contact email(optional)Relation to the participant

I confirm that the information I have provided is accurate, complete, and up to date. I understand that I am responsible for ensuring the information I submit is correct.

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Register as a participant

Register as a participant

Reason for consultation

Safety

Lifestyle and coping

Psychological / psychiatric history

Matching preferences

Emergency contact