Let’s Dig a Little Deeper

Take some time to answer the questions below, so I can learn more about you and let you know how working together could support your healing journey.

Name

First Name

Last Name

What is your age?

Briefly describe your main health concerns:

Are you working with any health care professionals? Please describe in detail.

Briefly describe your mental health history and any current concerns

Note: these don't need to be specific diagnoses, they can also be just symptoms

What would your ideal outcome be if we worked together?

In a couple sentences, please describe your current roles & lifestyle.

Hypothetical Example: Married for 10 years, recently divorced, 50% shared custody of kids. Work for a corporate company, 40 hrs./week, 2 days from home. Kids have active extra curricular schedule during week and weekends; I'm usually always on the go.

Please feel free to share any other information, concerns or specific questions for me.