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New client Form: Introduction Call
Your details
Name
*
Pronouns
Email
*
Phone
Therapy Past and Present Information
Have you had therapy before?
*
A
Yes, currently
B
Yes, in the past
C
No, this is my first time
Have you had therapy before
What brings you to therapy right now?
*
Safety and Background
Are you currently experiencing thoughts of harming yourself or others?
*
A
Yes
B
No
(Note: I am not an emergency or crisis service.)
Is there anything about your background or identities you would like me to be aware of?
*
(For example: multicultural, trauma, adoptee, LGBTQ+, neurodivergent.)
Consent and Next Steps
(This intro call is free of charge)
Consent 1
*
I understand this is an introductory call to explore whether working together is a good fit, and not a therapy session or crisis service.
Submit here and I will reach out to you soon to arrange a call.
Submit
