Before We Meet

Thank you for taking the time to complete this form before your first appointment. Your responses help me understand not only why you’re seeking my help, but also who you are as a person. No two minds are the same. Every session I conduct is designed specifically for you. There are no right or wrong answers. Simply answer each question honestly and as completely as you can. The more I understand before we meet, the more we can accomplish together during your session. I look forward to meeting you.

Personal Information
Emergency Contact
Health Information
Medical History
Previous Experience
Religious or Spiritual Background
Our beliefs often shape the way we view ourselves, our experiences, healing, and the world around us. I'd love to understand yours a little better. Please answer only what you feel comfortable sharing.
Your Reason for Coming
Looking Ahead

Imagine that our work together has been completely successful

Questions for Reflection