Gemini Sisters Farm Free Consultation Intake Form
Welcome

Thank you for your interest in therapy services at Gemini Sisters Farm. This brief consultation form helps us learn more about your goals and determine whether our services may be a good fit. Completion of this form does not establish a therapeutic relationship.

Email *
Full Name: *
Preferred Name: *
Phone *
Email: *
Preferred Contact Method: *
Required
Preferred Consultation Format
*All new clients require free consultation prior to intake session*
 *
Required
Preferred Day *
Required
Preferred Appointment Time *
Required
How did you hear about us? *
Required
Who are you seeking services for? *
What brings you to therapy? *
Consultation Acknowledgement: 
I understand this consultation is informational only, is not a therapy session, and does not establish a therapeutic relationship. Referrals may be offered if  services are not the best fit. 
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