Mindfulness Intake Form

Please fully complete the Intake Form below before your next session.

BASIC INFORMATION

YOUR ISSUE

MORE ABOUT YOU

HEALTH & FITNESS

RECENT LIFE CHANGES

CANCELLATION POLICY

We have a 24 hour cancellation / rescheduling policy: Cancelled, changed or missed appointments with less than 24 hours notice will result in the loss of that session (value $125). a fee of $70. This policy is in place out of respect for our therapists, and our clients, because an appointment cancelled with less than 24 hours notice results in a time slot that is difficult to fill, and giving last minute notice or no notice at all prevents others from being able to schedule into that time slot.Thank you for your understanding and cooperation.