New Client Intake.
Please complete the survey below. This will be used to shape our discovery call.

Question Title

* 1. First Name

Question Title

* 2. Last Name

Question Title

* 3. Email address

Question Title

* 4. Phone Number

Question Title

* 5. Mailing Address

Question Title

* 6. Birthdate

Date

Question Title

* 7. Are you currently taking any medication?

Question Title

* 8. Have you been to therapy or counseling before?

Question Title

* 9. Tell me about your home life (Ex: partner, spouse roommates, children pets etc)

Question Title

* 10. Describe your profession/career.

Question Title

* 11. List 5 adjectives to describe your current self.

Question Title

* 12. What values are important to you?

Question Title

* 13. Tell me about your typical day from morning until you go to bed.

Question Title

* 14. Why are you reaching out for support at this time?

Question Title

* 15. How soon would you ideally like to start your sessions/package?

Question Title

* 16. What times of day/days of the week are ideal for you to meet?

Question Title

* 17. Please rate your current joy level.

Question Title

* 18. Tell me about your favorite hobbies? Write about what you like to do for fun, and what makes you laugh/giggle/smile. 

Question Title

* 19.  How much time will you gift yourself to work on YOU each day?

Question Title

* 20. How do you want to feel after working together?

Question Title

* 21. How did you find Bring on The Joy?

Question Title

* 22. How often do you feel overwhelmed?

T