New ClientWelcome Form Contact Us Date First Name * Last Name * What do you prefer to be called? Email * Phone Number * Occupation/ Profession - What do you do for a living? Marital Status If married/committed relationship, what is their name and occupation? Do you have any pets? If so, what kind and what is/ are their names? Are you religious? Spiritual? Other? How do you spend your free time? Hobbies? Activities? Sports? Other? Have you ever sought help like this before? If yes, why? How did it go? What was your experience like? Why do you feel you need help now? What are your expectations? What are you hoping to achieve? Do you have goals? How did you hear about THEY? If you have goals, what do you see as the reason or reasons you aren’t achieving them? How do you feel about someone asking tough questions of you? If you are human, leave this field blank. Submit
