My office

2816 SE Harrison St.
Milwaukie, OR 97267

[In Person: Mondays only 12:30pm-5pm

Virtual: Mon: 10:30-12:00; Tues.,Thurs., Fri: 10:30am-5pm]

New Client Questionnaire

This form is thorough and specific to ensure that what you want and what I offer are a good match. I want you to find the best therapeutic fit, so thank you for answering honestly :)

* indicates a required field

Thank you so much for taking the time to fill this out!

I will get back to you soon, and if it seems like we may be a fit, the next step will be a free 15-30 minute virtual consultation.

If form wont submit, go back and ensure you filled out all the required fields indicated with a * next to the question, and that you chose two options in the questions that indicate you must do that.