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    Client Forms

    If you are interested in working with us one-on-one, please fill out this intake form.

    If you feel that you would like to collaborate your session with another provider, simply fill out the following form.

    We provide:

    – Therapeutic and coaching tools to help you with the emotional, behavioral, somatic, cognitive and interpersonal experiences you have that you want support in changing

    We do not provide:

    Clinical services, we do not diagnose or treat a condition, but we can give you a referral if needed.


    If you feel unsafe or are having a medical emergency, call 911(or your country’s emergency number) or go to your nearest emergency room.

    All information you share with us is anonymous and confidential unless you choose to share your name as part of the community. We agree that we will not reveal, make known, or use confidential information you share privately with us except as authorized by you or required by Law.