Inquiry Basic Questionnaire
Thank you for connecting with me. Here are a few basic questions to get us starting.
Are you able to commit to 10 sessions? *
Yes
No
Which area would you like to improve?
Relationships: Social, work place or personal.
Family challenges: As a parent or As an adult dealing with your parents.
Changes due to a relocation
General life changes.
Other.
If you choose "Other" please specify here:
Your name: *
Phone number and Email address *
please choose the best time to contact you during the day *