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New Client Questionnaire

Contact and General Information

Any information submitted is only shared with me, and you are not signing up for any kind of automated or spam communication! If you don't put anything, I won't be able to reach you!

Preferred Contact Method

I am only licensed to provide therapy to folks who are physically located in Missouri or Minnesota.

Where would you like to meet?
In-Person (Kansas City, MO in the Crossroads)
Virtual (Living in MO or MN, only available for clients 12 and older)

Tell Me a Bit About You

What services are you most interested in receiving? You can read more on the Services section of my website!
Would you like to schedule now or have me contact you?
Schedule Now!
Please reach out to me :)
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