Intake Form for Individuals

This questionnaire will help me get to know you and understand your reasons for seeking therapy. Depending on how detailed you choose to be, it should take around 10 to 20 minutes to complete. Please submit it before our first session together — ideally at least one day before, so I have time to review it.

The information you submit is private and confidential. Please refer to my Informed Consent (PDF opens in new tab) for details on keeping your health information secure.

If you prefer a paper form that you can fill out by hand, let me know. Just be aware that the process of completing and sending it back may take longer with paper.

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