New Client Intake
Before we begin,
Before we begin,
help me understand
where you are.
This form is the foundation of our work together. Your answers are confidential, read carefully, and used only to understand you — so our first session can go as deep as possible, as quickly as possible.
01
Personal Information
Contact details, background, and what brought you here
02
Your Relationship & Goals
Current situation, patterns, and what you are working toward
03
Health & Wellbeing
Relevant history, support systems, and therapeutic background
04
Consent & Agreement
Confidentiality, coaching agreement, and your signature
Intake Form Received
Thank you for
Thank you for
trusting me with
this.
Your intake form has been submitted. I will review it personally before our first session — not to evaluate you, but to understand you as fully as possible before we meet.
You will receive a confirmation email shortly. If you have any questions before your first session, do not hesitate to reach out directly.