Private Client Consultation Form
I am so thrilled you're interested in working together  

As a licensed therapist, certified coach, and educator I bring a really unique approach to this type of work and I'm beyond excited to see if we're a good fit.

The questions below will help us make that decision together.

Ready to roll? Fill out the form below!
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What is your full name? (first + last) *
What are your pronouns? *
What's your best email? *
What are the biggest frustrations or challenges in your relationship, sex life, or life in general right now? *
Let's say we work together for 4 months. 4 months from now, what would you like to see be different? What will change? What will be the same? (Go big here, think like you have a magic wand in your hands!) *
How passionate are you about seeing what you wrote above become a reality? *
What do you feel or think is holding you back from what you're wanting in your life/relationship/sex life? *
How did we meet? How did you find me? *
If we hop on our call and all determine that we are a good fit to work together, are you ready to fully invest (financially, mentally, + time) into yourself, your life + relationships right now? *
Have you worked with a therapist or coach before? *
Is there anything else you want me to know?
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