Client Intake

A starting point, in your own words.

This short form helps us begin from a real place. There are no right answers, and you don’t need to write much. A sentence or two for each question is enough, just whatever feels honest right now.

Takes about five minutes.

The basics

Helps me match this form to the right session. Leave blank if unsure.

Preferred contact method *

Some quick context

Have you done work like this before? *

Are you currently under medical or mental health care? *

How are you feeling emotionally today? (select any that fit)

For This Session

What would you like to focus on today?

List up to three main issues you’d like to work on. For each one, rate how strongly it’s affecting you on a scale from 1 (mild) to 10 (severe). This helps me know where to focus and lets us track shifts over time.

1 Main Issue

How strongly is this affecting you? *

MildSevere

Your responses are sent securely and reviewed only by Bryan.