Welcome! I'm so happy you're here.

Please complete the following so I can get a better idea of what your needs are and if I'm the right fit for you. Once I have all your details I'll be in touch!


Client Intake Form

Please answer honestly and to the best of your ability. There are no right or wrong answers. If the question is not relevant to you simply state N/A.
Briefly describe your dream life.
Briefly describe what specific ADHD/mindset challenges (beliefs, fears, internal dialogue etc) have prompted you to work with me?
How are these challenges impacting your daily life?
When did these challenges begin and what was going on in your life at the time?
We all have significant events in our lives that contribute to how we feel about ourselves, our abilities and what we deserve in life. What are the most significant events that you have experienced?
What beliefs (if any) did you form about yourself or the world as s result of these experiences?
Complete the following sentence as it relates to your life goals: "It would be really nice to have ________ but I can't because________".
How do your current challenges make you feel?
How will your life improve when these challenges are resolved? What will you start doing and what will you stop doing?
How do you want it to feel? Please be as descriptive as possible?
Please let me know if you have any questions for me.