Client Intake Form:Please fill out the form below prior to our session so that I can have a larger understanding of what to ask you. I can't wait to connect with you! Name * First Name Last Name Email Address * Phone Number * What are 5 things you are grateful for today? What would you like to work on with me? What are the areas that give you concern or are a problem? Please give a brief explanation (e.g., lower back, accident) and how long the concern has existed. Does anything make the areas or problems better or worse? Ideally, how do you want to feel when what you described and explained above is no longer a challenge? Describe your goals and expectations. Thank you so much! I am super excited to work with you. You have taken the first step towards a present, focused, and mindful you. The key to your freedom is awareness! My methods are exciting and unique and require commitment and effort, which you are showing already! Please know that I will be coaching and guiding you along the way each week. We will have sessions together two to three times weekly with improvement taking 2 to 6 months of commitment with me to realize a change.
