intake form

Thank you for your interest in working with me! This short form helps me understand your current goals and whether this 15-minute call will be the best next step for you. 

The 15-minute call is for individuals genuinely ready to explore deep psychoanalytic coaching or therapy work. 

If you are experiencing suicidal thoughts or are in crisis, please contact your local emergency services or suicide hotline immediately. This form is not suitable for emergency support.