New client intake form

Basic information about you

(For example: he/him/his, she/her/hers, they/their/theirs)
For example, home or work number
Please check all that apply

Emergency contact information

Background information about you

Please share as much or as little as you want--whatever you'd like me to know about you that you didn't get a chance to share during our initial call. If a question doesn't resonate with you, please feel free to skip it.
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