Client Intake Form
Assisting you is my top priority.
Truly, understanding you and your life situation is paramount to our time together.
Intake Form Overview
Please read carefully before selecting the best option
A client intake form is one way I can initially learn about you and your life process; these forms are 100% confidential. Sending me a completed form before our first session gives me a chance to familiarize myself with your life situation before our first scheduled meeting.
There are two versions of the client intake form – Condensed or Thorough – and each one can be either Filled out Online, or Downloaded and Printed (see links below).
If you are needing assistance and a listening ear around just one particular situation, I would recommend the CONDENSED client intake form.
On the other hand, it is important to note that even seemingly isolated situations are informed by larger life processes. If you think this is the case, or have more going on than just a single situation, I recommend filling out the THOROUGH intake form. Do not to feel obligated to fill out everything on this form, however, the more you do, the more familiar I will be with your situation ahead of time.
OPTION 1) Fill out either ONLINE FORM below for best results. Condensed form is first. SCROLL DOWN PAGE for the Thorough version.
OPTION 2) DOWNLOAD either form, and e-mail file to: contact@the-listener.com.
OPTION 3) PRINT either form, fill it out and mail it to: P.O. Box 4558, Arcata, CA 95518.
CONDENSED (SHORT) FORM:
Scroll Down page to fill out Online,
– OR –
Click button below to download PDF or DOCX file.
THOROUGH (LONG) FORM:
Scroll Far Down page (past Condensed Form) to fill out Online,
– OR –
Click button below to download PDF or DOCX file.
CONDENSED FORM — Please Fill-in as much as you can.
LONG FORM — Please Fill-in as much as you can.
Frequently Asked Questions
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