Pre-Consultation Questionnaire
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Email *
Name *
Phone *
Contact Preference
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What are you hoping to get out of this consultation? *
(So I can be sure to best serve you in our time together)
Will anyone else be on the phone with you? If so, who? *
What are some of the challenges you face in your relationship right now?
What have you already tried to address these challenges?
Books, therapy, coaching programs?
If anything is possible, what does your ideal relationship look like?
What is hold you back from this ideal relationship?
How did you hear about me?
I will call or Zoom with you at your scheduled time. If you have not yet scheduled a time, please use the online scheduler or contact me directly. Please type AGREE if you commit to showing up (or canceling 6+ hours ahead of time if you need to do so). *
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