The contact form, written like a conversation.

Just a hello to start — skip any question that doesn’t fit. There are no right answers; I am only trying to figure out whether we would work well together. The longer intake form comes later, and you can preview it below.

Preview the intake form

The form above is just to say hello. The fuller intake questionnaire comes after we’ve booked a first session — here’s exactly what it asks, so nothing’s a surprise.

• Your full name, and what you'd like to be called.
• Pronouns.
• Best email and phone — and which you'd rather I use.
• Time zone and the windows you're generally free.
• An emergency contact (name and number).

• In your own words, what's bringing you to coaching right now?
• If things went well, what would be different in six months?
• Have you worked with a coach or therapist before? How did it go?
• Are you currently working with a therapist or other provider — and may I be in touch with them if it's useful?

• Any diagnoses — formal or self-identified — you'd like me to know about.
• What helps you focus, regulate, or feel safe?
• What reliably makes things harder? (Sensory, social, demand, time of day…)
• How do you like to communicate between sessions, if at all?

• How did you hear about the practice?
• Would you like to talk about sliding scale?
• Anything about access I should set up before we meet? (Captions, breaks, camera-off, a slower pace…)
• Anything you're not ready to write in a form? That's fine — you can tell me later.