Welcome! This form helps me understand where you are before we meet so I can show up for you properly. There are no right or wrong answers. Please take your time and share only what feels comfortable.
Share as much or as little as you feel comfortable with.
Previous therapy, medication, self help, anything.
You can write none or unsure. This is completely optional.
Name, relationship and phone number of someone we can contact if we are concerned about your safety.
Anything at all. No pressure.
Before we meet I want you to know that everything shared in our sessions is strictly confidential. The only exceptions are if I have reason to believe you are at serious risk of harming yourself or others, if there is a concern involving a child or vulnerable adult, or if I receive a court order requiring disclosure. In any of these situations I will wherever possible speak with you first.
