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 Transform With Claire | 1:1 Session Inquiry Form

Hello! I'm grateful you've found your way here.

This inquiry form is meant to be completed prior to a consultation so that I can begin to determine which of my offerings might best suit your needs, and more effectively tailor our conversation to what's most important to you. 

As you complete the below questionnaire, please be as honest as you can/feel comfortable being. This is a confidential, safe and judgement-free space. I'm so proud of you for taking this step and so excited for what's to come in your journey. About 1:1 Sessions:
I intuitively blend approaches from various science-backed somatic modalities to gently guide you out of your thinking mind and into the body, allowing you more access to the thoughts, feelings, beliefs, attitudes, behaviors, and relational patterns that have obstructed you from living your full potential.

Sessions with me are customized, and often first aim to help you release stored emotion that can lead to triggers that disrupt your daily life and well being. Healing on the level of the body can be deeply transformational, as it can then reveal and help us work with the stories, beliefs, and patterns that may be holding us back from living the life we envision for ourselves. Sessions may include Somatic Coaching, Breathwork, Meditation and Mindfulness as well as various exercises from my toolkit.

* Please note, I am not a medical doctor nor psychologist. My work is influenced by years of self-study, mentorship, undergrad & graduate studies in Clinical Psychology, and certifications in Integrative Trauma Coaching, Breathwork, and Somatic Therapy. If you feel you are in need of medical attention, seeking a diagnosis, or interested in treating a mental health diagnosis, I lovingly encourage you to seek support elsewhere - and will do my best to help with referrals.*

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Email *
Name *
First and last name
Pronouns
Email *
Phone number *
Preferred method of communication
Location/Time zone *
How did you find me? *
Do you have any mental health diagnoses and/or medical conditions? If so, when were you diagnosed, and are you currently working with a professional for support with your diagnosis? 
 *
What do you do for work?
What best describes your current situation?
Do you have a specific intention for starting this journey? What are you wanting in your life right now? How do you hope this work will benefit you?
Which of the following modalities/practices have you tried? *
Required
Why are you interested in working with me?
What are your top 3 goals when it comes to healing and improving well-being?
 *
Which modalities/practices are you currently participating in? When did you begin this work, and how often are you doing it now? What has been helpful? *
What are the top obstacles standing in the way of your healing?
 *
What emotions/physiological reactions/symptoms are most prevalent for you? Describe how these affect your quality of life. *
Which offerings are you interested in? *
Required
What level of financial investment would be within your budget for this type of work?

This is to get an understanding of your maximum budget as we consider options for a complete treatment plan. We will work together to determine what best suits your needs. For reference, individual sessions start at $150, and multi-session packages, retreats, and other programs can range from $900-$5k.
 *
Are you ready to make this investment in yourself now?  *
Are you willing to commit to daily or weekly homework/personal practices in order to release the past, get unstuck, regain control of your nervous system, and become more fully present in your life?

this might include mindful minutes, meditation, lifestyle change, habit inventory, at home breathwork, somatic exercises, etc. *
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