[ Intake Form ]

Thank you for taking the time to complete the intake form. Please allow yourself 30-45 minutes to complete.

Some questions may seem very personal and may feel difficult to answer. Each question allows me to know more about you so we can maximize our time together in sessions. However, if there is any question you would prefer not to answer please know that is ok too.

This Information is held to the same confidentiality standards as counseling sessions. If possible, please print out this form and bring to your first appointment.

Thank you.

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