The Relationship Upgrade: Application
Upon completion of this application, I will get back to you within 24 hours. If we are a good fit, I will send all of the details to get started.
* Required
Name
*
First and last names
Your answer
Emails
*
Your answer
Phone numbers
*
Your answer
Tell me a little bit about yourselves and what you're looking to gain from our work together.
*
Your answer
Are either of you dealing with certain issues (such as intense trauma, clinicial levels of depression/anxiety, etc.) that may make traditional psychotherapy a better fit for you at this time?
Yes
No
Maybe
Clear selection
Please elaborate if you wish.
Your answer
What is your level of commitment to working together for 12 weeks?
Your answer
Do you have any questions for me about this program?
Your answer
Thank you so much for taking the time to apply - I will be in touch shortly!
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