Client Forms & Policies

Please call to make or change an appointment. You may also click here to purchase services online.

Referring  a potential client 

I especially appreciate client-to-client referrals. To make that process easy, please download this referral card, which opens in pdf, to attach to an email or print out for someone who could use my help.

Please download the Welcome Packet below to update your records and use the link above to make a payment.

If you would like to become a client, please call 1.866.821.9386 or email now to set up your complimentary consultation.

Find out just how quickly you can get started changing your Life Scripts.

New Client Welcome Packet

Please return required forms via:
email: here
fax: 1.866.821.9386


Intake Form
Service Agreement
Client Policies

Optional and Useful

Session Preparation Form


Client Policies


__Missed sessions will be made up if rescheduled 48 hours prior to your regularly scheduled time.

__Sessions cancelled for non-emergency reasons with less than 48 hours notice will not be made up.

__Your weekly time is your time and cannot be reassigned.

__Service package fees are paid in advance.

__There is limited flexibility for session-by-session fees, but between-session support and any other services are not available with this option.

__Payment must be received in advance of service.

__You may terminate a package agreement at any time, provided all appropriate fees for sessions used have been paid.

__Package fees will not be refunded for unused sessions unless by mutual agreement. Any agreed upon refunds of unused fees will be processed as quickly as possible.

__I take your privacy very seriously and will protect your personal information to the best of my ability. I expect that you will protect yourself as well. See my privacy policy and terms of use at by clicking on ‘privacy’ at the bottom of each page.

__Please review my terms of use before submitting a payment.

Please read this document carefully and sign below indicating you understand and accept the policies and that you have reviewed the privacy and terms of use policies found at

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