Getting to Know Your Questionnaire

Getting to Know You Questionnaire

  • These questions are going to assist me in understanding your needs and working with you from where you are today to the balanced lifestyle you desire and deserve. I appreciate your thoughtful answers and your willingness to share personal information with me. We will work together to achieve a calm, safe, secure, non-judgmental relationship for many unique, counseling experiences for your success.
  • Our goal is to understand and implement viable solutions for one of your challenges each month, making any adjustments needed and following through to observe the results while sharing the joy.
  • Are you or anyone in your environment concerned with any of these issues or others, that would affect your life?

    Alcohol or substance abuse
    Alzheimer’s
    Anxiety
    Autism
    Behavior Challenges
    Depression
    Domestic Violence
    Eating Disorders
    Neurodegenerative Disorders
    Other