A complete health history is required to be completed at least 24 hours before our first session together. Late submissions may require us to reschedule our appointment (cancelation fee may apply).

Please fill out this form as thoroughly and honestly as possible. The information requested is to better help us understand you and how we can effectively help you achieve your goals in our work together. We firmly believe that each person is unique and no one program is going to work for everyone. We appreciate your vulnerability and openness in completing this questionnaire.  

It should take about 20-30 minutes to complete this intake form.