Personal Inquiry Interest form

Pre-Consultation Interest Form

Please note form is for Personal Inquiry Only, not for Therapeutic services. Please visit Contact Page for Therapeutic Services.

Phone number *

Please specify your above selections *

Name: *

Email: *

Please select your area/s of inquiry (select all that apply) you wish to explore *

Creative Block

Decision Making

Dream Exploration

In-depth exploration of a particular topic

Life Transitions

Processing/ unpacking/integrating experience(s)

Other (Please specify below)

I need help narrowing down what I want to explore/ I'm not sure