Jamie Cutino, Master of Occupational Therapy
I'm really proud of you! Seeking change can be scary, especially when you don't know who will truly be helpful and worth your time, energy, and financial investment. 

Take a deep breath, and know that you're in good hands! This is just a form that I require on the front end, so that I can gear your readiness for change. 

Filling out this form does not guarantee or commit you to services. The way that I deliver services is much more hands on than many therapists and coaches, which is why I will be limiting the number of clients I accept. 

After filling this out, my team will reach out via text and email within 3-5 business days to schedule a consultation. 
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What are you struggling with? Select all that apply.
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I'd love to know more about what you're struggling with, in your words.
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Do you currently see any other medical professionals to treat your ADHD? Select all that apply.
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Are there any barriers in the way of you receiving treatment/help for your ADHD? Select all that apply.
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I believe that women with ADHD are the most creative and resourceful people on this planet! How will you overcome this obstacle?

If not applicable, respond, "NA."
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What aspects of your life are you most excited to improve?
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How did you hear about Outsmart ADHD?*
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Who (if anyone) told you about Outsmart ADHD? Please write NA if not applicable.
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My team will reach out via text and email to confirm your spot!
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