First Name *

Last Name *

Phone

Email *

What brought you here right now? *

I feel stuck or fragmented

I’m functional but disconnected

I’m overwhelmed or burned out

I’m doing well externally but something feels off

I’m preparing for a deeper phase of life

I’m not sure — I just know I need something different

Select any that apply

How does your life feel most days? *

When pressure increases, you usually... *

What hasn't worked for you, or you don't want more of?

What kind of support feels most helpful right now? *

How involved do you want support to be right now? *

Some deeper work can involve gently exploring earlier life experiences later on, always with consent and pacing. Which best reflects your comfort level right now? *

Anything important you want us to understand about you or your boundaries?

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