Joko Wellness, LLC therapy consultation intake
this intake will be used to learn about your therapy needs and ensure fit. Oumou will be in contact within 3-5 business days to schedule a phone/video consultation (barring any physical or mental health needs that will be centered).

head to https://www.connectwithoumou.com/clinical-services/ to read more about Oumou and their practice.
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Email *
what is your name? what are your pronouns? *
what are you looking for support with? what problems do you notice in your life? what part of your life makes you wanna pack up and run away? what do you desire? *
what's your level of urgency around solving this problem/achieving your desires? *
not in a rush to start, just therapist shopping
I was ready yesterday and can start tomorrow
have you been in therapy before? *
Required
what are some of your expectations about therapy and about having a therapist? *
what lead you to reach out to me? how did you find me? *
what's your availability for sessions? *
do you live/reside in New York State? *
I confirm that I am aware that Joko Wellness, LLC's fees are $210 per individual session, does not accept in-network insurance and has limited reparations and solidarity rates available. *
Required
based off the questions in the anti-oppression rate questionnaire, what level are you at? what is your budget for sessions? *
any additional info about yourself or your context that you'd life to share?
A copy of your responses will be emailed to the address you provided.
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