Workshop Intake Form
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Email *
Name(s)*

*Please use the name(s) you're most comfortable with, that you'd prefer I use during our workshop
 *
What pronouns do you [both] use?  
How would you like me to refer to you [both]?

i.e. He/Him; She/Her; They/Them; Ze/Zer; other
 *
What is the best phone number to reach you at?

*Please note for privacy reasons I am unable to engage in text conversations
 *
If this is a home session, please provide your home address*

*Please let me know if you have any pets in the home and if they are able to be secured during our session
How did you hear about me?

(Why am I asking?  I love to say thank you for the referrals as they are such an invaluable part of building my business!)
 *
Required
Is there anything else you would like me to know?
Do you have any specific questions about this topic you'd like to ensure I cover during the workshop?
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