Interest Questionnaire


Thank you so much for your interest in working with me during this phase of your life!  

Reaching out is the most important step, so before you even get start, take a moment to congratulate yourself on valuing your life and your future enough to want to make some changes.

Please answer each question honestly...don't try to answer it based on what you think I want to hear.  All I want to hear is how you truly feel and where you currently are in your life.

Once you submit your form, I will review it and get back to you within 1 week. 

I look forward to hearing from you!


Name *
Are you currently being treated by a professional therapist? *