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Thank you for your interest in working together.


This form helps me get a sense of what’s bringing you here and whether my approach is the right fit for your needs.


Please share as much or as little as feels comfortable — there’s no need to go into detail at this stage.


Once I’ve received your form, I’ll be in touch to suggest the next step, which may include a short consultation call.

Birthday
Day
Month
Year
Are you currently taking prescribed medication for your mental health?
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