New Client Inquiry

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New Client Inquiry

Thank you for being here. Reaching out is a brave and meaningful first step toward the change you’re ready for, and I’m honored you’re considering working together. Please take a few moments to share about yourself so we can explore how I can best support you in this next chapter.

Submitting this form does not guarantee ongoing services or immediate availability. Please allow up to one week for us to review and respond. If you are in crisis, please call 911 or the Kern County Crisis Line at 800-991-5272. This form is not monitored for emergencies.”

Email *

Please add todays date *

YYYY

Please share your first name *

Please share your last name *

Please share your Date of Birth *

✨ May we text this number to coordinate appointments and communication? Please note that while we are mindful of your privacy, texting is not HIPAA-secure.

Yes

Please share your telephone number so we can connect by text *

We appreciate your commitment to your self-care and your willingness to explore change. What is calling you to reach out right now? What would you like to shift, heal, or grow in your life? Please share as specifically as you feel comfortable so we can understand how best to support you. Take your time.

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