Application

I’d love to learn about how I can serve you!

To help me understand your present challenges, history and goals, please fill out the form below.

A member of my amazing team will respond within 2 business days. Your application will be carefully reviewed. Where appropriate, a complimentary consultation call will be arranged. In the call, you’ll get a sense of me, and I’ll happily answer questions plus make program recommendations.

For general scheduling inquiries, please contact us here.

 

Please complete the form below

Name *
Name
Birth Date *
Birth Date
Phone *
Phone
City, Province/State, Country
If referred by a client, who was it? If other, please explain.
1. Which session format calls to you? *
Check all that apply.
2. Have you experienced any trauma in the past year? *
6. Sign up to receive inspiring updates and a complimentary e-book *
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