Intake Questionnaire


Getting to know you better...

Please take some time to reflect and answer the questions. This will allow the therapist more insight on what your needs are, the nature, severity, and impact of your difficulties, to assess any functional impairment, and your stressors, along with your strengths and resources. 

By filling out Intake questions ahead of time, this will allow the therapist more face-to-face time with you at your first visit to help build your treatment plan with you and begin your journey to emotional wellness.

There are 23 questions which should take you about 10-15 minutes to complete. You will need internet access to complete or you can ask for a printed copy to be emailed to you if you prefer!

Neurofeedback Forms

Download the Neurofeedback Assessment form and fill out the symptoms your are experiencing, rating them from 1-10, 10 being the worst. 

Symptom-Tracking (pdf)