CONFIDENTIAL INTAKE FORM

Thank you for your time during our initial consultation.

Please answer the following questions to the best of your ability. Please use as much space as you need for each answer. This information is strictly confidential and will not be seen by anyone else. It is encrypted both in transit and while stored. If there are any answers you prefer to give in person during our session, just let me know.

Once I have reviewed your information, I will be in touch with any follow-up questions or to schedule our initial session. This will normally take no more than two working days. I will request a 20% deposit to confirm the date, with the balance due no later than two weeks before our session.