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New Clients

30min Initial Consultation

Good for you! Now follow these steps.

  1. Submit this form to help us get to know you better.

  2. Schedule your initial call and make your deposit.*

*A small non-refundable deposit of $35 is required to reserve.

Good news is you’ll get $25 + coupon by email after your call.

New Client
Receive your $25 + coupon in your email after your initial consultation.
Name *
Name
Phone *
Phone
Age *
You must be 18 or older. Under 18 requires a parent or guardian to complete this form on their behalf.
Gender
How do you serve the world?
Do you have finances to invest in yourself? *
Services are self pay and we do not accept insurance of any kind.
MEDICATION
Do you take any of the following types of medications? *
Are you interested in having a custom support plan to help you taper off of your medications? *
CHOOSE YOUR FOCUS
What type of service do you need? *
Have you worked with one of these before?
Presently or Past. Choose all that apply
Personal
If applicable please select your top 2 areas of focus.
Premarital & Marital
If applicable please select your top 2 areas of focus.
How did you hear about us? *