Ready to start healing?

The first step is always the hardest step to take. So let's make that easier for you.

Answer the below questions to the best of your ability. Remember, there are no right or wrong answers. These answers provide me with insight to help me find a solution that works best for you. Take your time to fill each one out.

Find out if holistic anxiety solutions are right for you.

*Please note there is a wait list for new clients. Due to the high demand of new clients, not everyone will be approved. Once you apply, your application will be submitted for review and you will be contacted with more information.

First name

Last name

Phone

What is your overall reason for wanting to book?

How long have you been struggling with this?

What have you done for relief and how successful has it been?

Are you currently taking medication for anxiety or depression?

Have you undergone any life transitions in the past year- Grief, heartbreak, death, end of a relationship, career change, move, parenthood, miscarriage, medical issues/ surgery, change, etc. Please explain any changes even if not listed above.

Do you have stomach or digestive problems? Please note even if you do not have a diagnosis, please explain how stomach issues show up for you. For example, nausea, stomach pain, diarrhea, constipation, abdominal bloating and or pain.

Do you feel lost or confused with where you are in your life? For example, do you find yourself wondering or contemplating the meaning of life or what your purpose is?

Are you an emotional/ sensitive person?

Do you often feel like you are doing things for others happiness and unsure of what makes you happy?

What is your overall hope in seeking help and guidance from me?

Please provide any additional information that you think may be helpful for me to know.

Please select a time of day that works best for you to be contacted during the week.