Please return this form no later than 48 hours before the start of our session.

NOTE: This client intake form has double encryption for confidentiality. After completing the form, all your answers are encypted. For your security, any information are not saved as a draft, should you step away. 

Here are some helpful tips to complete this form:

➡️Because your answers are not saved as a draft, I recommend that, as you write your long-form answers, transfer them to another notepad or Word Document, in the event of a time-out, to avoid losing your work.

➡️Read and review each question and answer them to the best of ability.