Therapy Questionnaire

Hi ,

In order for me to help you in the best way possible, please fill out the following questionnaire.  It is important that all fields are filled out completely.  The better picture I have of your unique situation, the more I can tailor the therapy to your needs.  Because this can take some time, you can save the questionnaire and come back to it at a later time.  After you have submitted the form, I will reach out to you to schedule our session.

Thank you.

Jason